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31A-284 (6) SM-2023-0013 112 WASHINGTON AVE COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 31A-284-001 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-2023-0013 PERMISSION IS HEREBY GRANTED TO: Project# renovation Contractor: License: Est. Cost: 447000 JOHN HAMILTON Const.Class: Exp.Date: KENNEDY, T. PATRICK & KENNEDY, BEVERLY Use Group: Owner: G. Lot Size (sq.ft.) Zoning: URA Applicant: TIN MAN HEATING AND AIR COND Applicant Address Phone: Insurance: 39 SPRING ST 413-527-7722 WCB30293 EASTHAMPTON, MA 01027 ISSUED ON: 04/03/2023 TO PERFORM THE FOLLOWING WORK: INSTALL 2 SHEET METAL HEATING &AC SYSTEMS WITH 1 ERV 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: ,,9 , ,, ,,,, Fees Paid: $50.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner 2 Commonwealth of Massachusetts City Of Northampton Da e Oa cc h q1 Doc4 Sheet Metal Permit Permit# 5 M-zo z3 - 0013 Estimated Job Cost: $ $i D 00, O 0 Permit Fee: $ \60, 0 0 Ck U Plans Submitted: YES NO V Plans Reviewed: YES NO Business License# / O 143 Applicant License# y 0 43 Business Information: PropertyOwner/Job Location Information: Name: j/1 -}100 f i �1V A c./TliC Name: T nc -r i c-K e►�t1 e�. Streetdq c C k n S-1 Street: ) 2 �'J aS h i 11 q -t��(l . A J e City/Town: ct s amp-6 n i City/Town: (4"4'1 r.(cN►0-4 Telephone: Lf( A - ,7)t6 - n3 9,5 Telephone: Photo I.D. required/Copy of Photo I.D. attached: YES /NO Staff Initial J-1 /M-1-unrestricted license J-2/M-2-restricted to dwellings` li 3-stories or less and commercial up to 10,000 sq. ft. /2-stories or less Residential: 1-2 family V Multi-family Condo/Townhouses Other Commercial: Office Retail Industrial Educational Institutional Other Square Footage: under 10,000 sq. ft. y over 10,000 sq. ft. Number of Stories: Sheet metal work to be completed: New Work: Renovation: ✓ HVAC Metal Watershed Roofing Kitchen Exhaust System Metal Chimney/Vents Air Balancing Provide detailed description of work to be done: 1-() +a I i n a Co(-1-(Yt qrJ ,4 C S ys rms i -l'1 f e e v A /I nlefq ( 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,$100.00 Commercial INSURANCE COVERAGE: �,/ I have a current liahitify insurance policy or its equivalent which meets the requirements of M.G.L.Ch. 112 Yes Lid No❑ If you have checked Yes,indicate the type of coverage by checking the appropriate box below: A liability insurance policy 14 Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER:I am aware that the licensee drum not haves the insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that my signature on this permit application waivQsthis requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent By checking this box63,I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Duct inspection required prior to insulation installation: YES NO Prngrpee Ineppctioi s Date Comments Fip el Incpprtinu Date comments Type of License: By aster Title ❑Master-Restricted City/Town ❑Joumeyperson Signature of Licensee Permit# ❑Joumeyperson-Restricted Li( License Number: Li Pee$ ❑ fit ' Check at wwu+mace dnv/drl Li/3/9-3 inspector Signature of Permit Approval t • P9I8tiI F .;rror:+ w" IMO Goa I.71: • tbB>�1,�IutotlEpll'lIID11dllJ H Q�'' e S10H119 pw , N01111NV. ; J IPISUEEN4 sow.. 301111 eatMatidi ; S H V : Fold,Then Detach Along All Perforations s • u td. AAeti t` la ' 11'1'°" v Mal. � DIVISION OF OCCUPATIONALLICEPISURE BOARD'OF SHEET METAL WORKIHB owes THE FOLLOWING LICENSE IIINA$TER-LIN NESTINICIW J M C INAISIL1IOt 11 SPRING /� Fri ST NH3 1110221/23 333743 LICENSE NUMBER EXPIRATION DATE SERIAL NI!IMBER AC�® r DATE(MM/DDIYYYY) �, CERTIFICATE OF LIABILITY INSURANCE 03/31/2023 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 Elizabeth Carballo,CISR,CPIA NAME: Finck&Perras Insurance Agency Inc. PHONE Ext): (413)527-5520 FAX(A/C,Na) (413)527-5970 CA/6 Campus Lane E-MAIL bcarballo@finckandperras.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC C Easthampton MA 01027 INSURER A: Main Street America Assr Co 29939 INSURED NGM Insurance Company14788 INSURER B: Tin Man Heating&Air Conditioning Inc. INSURER C: 39 SPRING ST INSURER D: INSURER E: EASTHAMPTON MA 01027-2354 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2311807012 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 _ (MM/DD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 500,000 CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 10,000 A MPB30293 01/08/2023 01/08/2024 PERSONAL BAovINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2.000,000 —1 POLICY PRO 2 000 000 JECT LOC PRODUCTS-COMP/OPAGG $ OTHER: IDRC $ 25,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY _ AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N B ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? n N/A WCB30293 02/10/2023 02/10/2024 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Proof of Coverage CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Northampton ACCORDANCE WITH THE POLICY PROVISIONS. 210 Main Street AUTHORIZED REPRESENTATIVE Northampton MA 01060 Z;f4kfa ,. 44. fa I ©1988-2015 ACORD CORPORATION. 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