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31D-127 (2) SM-2023-0004 61 MASONIC ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 31D-127-001 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-2023-0004 PERMISSION IS HEREBY GRANTED TO: Project# 2021 HVAC UPGRADE Contractor: License: Est. Cost: 16000 PAUL TATRO Const.Class: Exp.Date: Use Group: Owner: CO NEW ENGLAND TEL& TEL Lot Size (sq.ft.) Zoning: CB Applicant: DEE SERVICES INC Applicant Address Phone: Insurance: 999 RIVER RD (413)789-0800 A0198189006 AGAWAM, MA ISSUED ON: 01/31/2023 TO PERFORM THE FOLLOWING WORK: HVAC UPGRADE 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: Varo, Fees Paid: $112.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner : 07:(,47:1VM Commonwealth of Massachusetts JAN a Q 2023 pity Of Northampton A iNsPFCTioNs Sheet Metal Permit Date: 1/23/2023 •naomco Permit# /Y► — -j — Estimated Job Cost: $ 16,000.00 Permit Fee: $ 112.00 CK i?J 7 7 C ip Plans Submitted: YES X NO Plans Reviewed: YES NO Business License# 673 Applicant License# 6483 Business Information: Property Owner/Job Location Information: Name: Dee Service, Inc. Name: Verizon Real Estate Street: 999 River Rd Street: 61 Masonic St City/Town: Agawam City/Town: Northampton Telephone: 413-789-0800 Telephone: Photo I.D. required/Copy of Photo I.D. attached: YES X NO Staff Initial J-1 /I'I-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 x Square Footage: under 10,000 sq. ft. x over 10,000 sq. ft. Number of Stories: Sheet metal work to be completed: New Work: Renovation: X HVAC X Metal Watershed Roofing Kitchen Exhaust System Metal Chimney/Vents Air Balancing Provide detailed description of work to be done: Extend Existing Duct to Serve the Computer Room and connect to new Equipment 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, $100.00 Commercial INSURANCE COVERAGE: I have a current Jiability insurance policy or its equivalent which meets the requirements of M.G.L.Ch. 112 Yes No 0 If you have checked Yes,indicate the type of coverage by checking the appropriate box below: A liability insurance policy IJ Other type of indemnity El Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee rinPc not have.the insurance coverage required by hapter 112 of the Massachusetts General Laws,and that my signature on this permit application waive.sthis requirement. Check One Only Owner ❑ Agent Signature of Owner or Owner's Agent By checking this boxW,I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Duct inspection required prior to insulation installation: YES NO ProgrPcc jncrectinns nate ('nmmenty Final Inc/wet-inn nate Comments Type of License: BY ® Master ��— Title 0 Master-Restricted City/Town ❑Journeyperson Signature of Licensee Permit# ❑Journeyperson-Restricted License Number: 6483 Fee$ ❑ Check at WWW macs dnv/rtp) �� , . � , • I/3)/ 3 � I Inspector Signature of Permit Approval DEESERV-01 BROOKE ACORN CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDYYYY) 1/26/2023 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 Brooke Barre NAME: Phillips Insurance Agency,Inc. PHONE No,Ext (413)594-5984 FAX 413 592-8499 97 Center Street l ): (A/C,Nog( Chicopee,MA 01013 ADDRESS:brooke@phillipsinsurance.com INSURER(S)AFFORDING COVERAGE NAIC A INSURER A:Middlesex Insurance Company INSURED INSURER B: Dee Service,Inc.of Springfield INSURER C: 999 River Road INSURER D: -e- Agawam,MA 01001 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 TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER IMMIDD/YYYYI (MM/DD/YYYY) LMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR A0198189 10/1/2022 10/1/2023 DAMAGETORENTED 500,000 PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 X POLICY X spa X LOC PRODUCTS-COMP/OP Ac-G $ 2,000,000 OTHER: $ COMBINED SINGLE LIMIT 1,000,000 A AUTOMOBILE LIABILITY (Ea accident) $ _ ANY AUTO A0198189005 10/1/2022 10/1/2023 BODILY INJURY(Per perso_ n $ __ OWNED X SCHEDULED AUTOS ONLY AUTOS yyry p BODILY INJURY(Per accide nt) $ X AUTOS ONLY X AUTO ONLY (Per accident) DAMAGE $ $ A X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 2,000,000 EXCESS LIAB CLAIMS-MADE A0198189007 10/1/2022 10/1/2023 AGGREGATE $ 2,000,000 DED X RETENTION$ 0 $ A WORKERS COMPENSATION Xy PER STATUTE ER AND EMPLOYERS'LIABILITY Y N A0198189006 10/1/2022 10/1/2023 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE N N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below _ E.L.DISEASE-POLICY LIM IT $ DESCRIPTION OF OPERATIONS I LOCATIONS/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 Cityof Northampton THE EXPIRATION DATE THEREOF, NOTICE Wig_ BE DELIVERED IN P ACCORDANCE WITH THE POLICY PROVISIONS. Building Commissioner's Office 212 Main Street Northampton,MA 01060 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD • MASSACHUSETTS DRIVER'S ,i„ LICENSE 03/09/2022 Id NUMBER 314 04/01/2025 .1 DOB 04/01/1966 s D SS I2 REST �,f END NONE TATRO 0, i _ PAUL DONALD a 8 30 AUTUMN RIDGE RD i �'y LUDLOW,MA 01056.3258 P EO) 18EYES BLU 15 SE%M 15 HGT 6%02" 04/01/66 Gam•-`�j"/,/ 5 DD 03/09/2022 Rev 02/22/2016 7 COMMONWEALTH OF MASSACHUSETTS DIVISION OF OCCUPATIONAL LICENSURE BOARD OF SHEET METAL WORKERS ISSUES THE FOLLOWING LICENSE W MASTER-UNRESTRICTED a PAUL D TATRO y 30 AUTUMN RIDGE RD W LUDLOW, MA 01056-3258 12 V..J 6483 04/28/2024 239590 LICENSE NUMBER EXPIRATION DATE SERIAL NUMBER A