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32C-198 (9) SM-2023-0038 107 WILLIAMS ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 32C-198-001 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-2023-0038 PERMISSION IS HEREBY GRANTED TO: Project# 2023 NEW 8 UNIT BUILDING Contractor: License: Est.Cost: 2600429 JESSE FORTIER Const.Class: Exp.Date: Use Group: Owner: LLC.4 ACES REALTY, Lot Size (sq.ft.) Zoning: URC Applicant: ROCK VALLEY HVAC Applicant Address Phone: Insurance: 1 MAIN RD 4135357804 WESTHAMPTON, MA 01027 ISSUED ON: 12/20/2023 TO PERFORM THE FOLLOWING WORK: HVAC FOR NEW BUILDING 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: gri 11 Fees Paid: $50.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner 3 /9f RECEIVED Commonwealth of Massachusetts City Of Northampton DEC 1 8 0023 Sheet Metal Permit DEPT.OF BUILDING INSPECTIONS Date: 12/14/2023 Permit# NORTHAMPTON.MA01060 Estimated Job Cost: $ $130.000.00 Permit Fee: $ Plans Submitted: YES NO Plans Reviewed: YES NO Business License# 824 Applicant License# SM2626 Business Information: Property Owner/Job Location Information: Name: Rock Valley HVAC(Jesse Fortier) Name: 4 Aces Realty,LLC Street: 1 Main Road Street: 107 Williams St. City/Town: Westhampton City/Town: Northampton Telephone: (413)535-7804 Telephone: (203)893-1158 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 3-stories or less and commercial up to 10,000 sq. ft. /2-stories or less Residential: 1-2 family Multi-family Condo/Townhouses V Other Commercial: Office Retail Industrial Educational Institutional Other Square Footage: under 10,000 sq. ft. ✓ over 10,000 sq. ft. Number of Stories: 3 Sheet metal work to be completed: New Work: V Renovation: HVAC V Metal Watershed Roofing Kitchen Exhaust System Metal Chimney/Vents Air Balancing Provide detailed description of work to be done: Provide and install Broan B130E65RT ERV systems. Complete all ducting for ERV systems. All ductwork to be installed in conditioned space. All ductwork to be sealed and insulated in accordance with state and local code + energy star standards. 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,$100.00 Commercial INSURANCE COVERAGE: I have a current Jiahility insurance policy or its equivalent which meets the requirements of M.G.L. Ch. 112 Yes® No❑ If you have checked YPs, indicate the type of coverage by checking the appropriate box below: A liability insurance policy ® Other type of indemnity ❑ Bond Cl OWNER'S INSURANCE WAIVER: I am aware that the licensee rinPs not haves the insurance coverage required by Chapter 112 of the Massachusetts General Laws, and that my signature on this permit application waivesthis requirement. Check One Only Owner ® Agent ❑ Signature of Owner or Owner's Agent By checking this box®,I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Duct inspection required prior to insulation installation: YES V NO Progress Inspections ( omillent Final Incwctiort nolo Contwcmts Type of License: By ® Master Title E Master-Restricted City/Town ❑Journeyperson Signature of Licensee Permit# ❑Journeyperson-Restricted License Number: SM2626 Fee$ ❑ ^^ , Check at www macs rgnv/dpt P/aO/D-S I Spector Signature of Permit Approval AC'C)RD' CERTIFICATE OF LIABILITY INSURANCE DATE(MMlDDYYYY) 4.."- 12/15/2023 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 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 CONTAC, ----+ K.S.K.INSURANCE AGENCY,INC. PHONE fA/C" F,,p(413)527-7859 4.Net(413)527-8314 203 Northampton St. MAIL :ADDRESS: daWDpepif4ksk-iDSUraf1Ce.COM P.O.Box 597 INSURERISI AFFORDING COVERAGE NAIC# Easthampton MA 01027 INSURER A: SAFETY INSURANCE INSURED INSURER B: SAFETY INDEMNITY INS CO Rock Valley Heating and Air Conditioning Inc INSURER C: WESCO INSURANCE CO 1 Main Road - INSURER D: Westhampton, MA 01027 INSURERS: 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 01 HER 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,SUBRI POLICY EXP LTR TYPE OF INSURANCE 1INSD YVVO1 POLICY NUMBER 'i MDDY/YYril 1MM/DD/YYYYT LIMITS X COMMERCIAL GENERAL LIABILITY 33a-•-- EACH OCCURRENCE ,$1,000,000 A I CLAIMS-MADE X OCCUR L DAMAGEI ENTED FREW -- $SO,000 Y BMA0024116 08/28/2023 08/28/2024 MED EXP An one srscn $10,000 - ---- .--- ---.._._.._ PERSONAL&ADV INJURY $1,000,000 GENT AGGREGATE LIMIT APPLIES PER: X POLICY n JPRO- ECT LOC GENERAL AGGREGATE $2,000,000 I PRODUCTS-COMP/OP AGG $2,000,000 OTHER: �_ $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT aui>tarW $1 MIL CSL B 1 1 ANY AUTO _ .BODILY INJURY(Per person) $ I ALL OWNED SCHEDULED I. AUTOS X .AUTOS 8234540 08/10/2023.08/10/2024 BODILY INJURY(Per accident) $ � X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS j $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ } EXCESS LIAB CLAIMS-MADE, AGGREGATE $ ._ DED RETENTION 4 - '$ WORKERS COMPENSATION S AND EMPLOYERS'LIABILITY Y/N r- SWUM__ ER _ H . C ANY PROPRIETOR/PARTNER/EXECUTIVE L.EACH ACCIDENT $500,000 OFFICER/MEMBER EXCLUDED? N/A WWC3663037 08/12/2023 08/12/2024 E. (Mandatory In NH) E L.DISEASE-EA EMPLOYEE $500,000 I. es,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 )ESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) -IEATING AND AIR CONDITIONING INSTALLATION,MAINTANENCE REPAIR IOB: 3C: :ERTIFICATE HOLDER CANCELLATION City of Northampton SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 212 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Northampton MA 01060 AUTHORIZED REPRESENTATIVE /! ,44 ,0,4„:"r." tV Q 1988-2014 ACORD CORPORATION. All rights reserved. CORD 25(2014/01) The ACORD name and logo are registered marks of ACORD ACORO' AGENCY CUSTOMER ID: 4520 4.D a *D, LOC#: 1 ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMED INSURED K.S.K.Insurance Agency,Inc. Rock Valley Heating and Air Conditioning Inc. POLICY NUMBER 1 Main Road Westhampton,MA 01027 CARRIER NAIL CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: FORM TITLE: BUSINESS OWNERS POLICY# BMA0024116 EFFECTIVE 08/28/2023.08/28/2024 ADDITIONAL INSURED---OWNERS,LESSEES or CONTRACTORS when required by written contract or agreement by endorsement SB 13 07 04 16 BLANKET WAIVER OF SUBROGATION when required by written contract or agreement by endorsement SB 13 07 04 16 PRIMARY and NON CONTRIBUTORY when required by written contract or agreement by endorsement SB 13 07 04 16 10 day notice of cancellation for non payment 30 day notice of cancellation for any other reason COMMERCIAL AUTO POLICY POLICY#6234640 EFFECTIVE 8/10/2023-08/10/2024 PRIMARY AND NON CONTRIBUTORY BLANKET ADDTIONAL INSURED when required by written contract by endorsement SCA 002 04 17 BLANKET WAIVER OF SUBROGAGTION when required by written contract by endorsement SCA 002 04 17 10 day notice of cancellation for non payment (CORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Initial Construction Control Document To be submitted with the building permit application by a �� Registered Design Professional � for work per the 9th edition of the ;••k" Massachusetts State Building Code, 780 CMR, Section 107 Project Title: 107 Street housing Date: 12.12.2022 Property Address: 107 Street,Northampton Ma, Project: Check(x)one or both as applicable:_X_New Construction_Existing Construction Project description: New HVAC systems I,James P Stroke PE,MA Registration Number:20068 Expiration date:June 31,2023,am a registered design professional, and I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning': Architectural Structural X Mechanical Fire Protection Electrical Other: for the above named project and that to the best of my knowledge, information,and belief such plans,computations and specifications meet the applicable provisions of the Massachusetts State Building Code,(780 CMR),and accepted engineering practices for the proposed project. I understand and agree that I(or my designee)shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review,for conformance to this code and the design concept,shop drawings,samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. When required by the building official, I will submit field/progress reports(see item 3.)together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I will submit to the building official a`Final Construction Control Document'. r";OF/4%4'y� p FAMES P. YN F stnoKE 4" NO 20068 :orqss2i� titE fro a", 410110 Enter in the space to the right a"wet"or electronic signature and seal: Phone number:413-626-8752 Email:ddangelo@tjconway.com Building Official Use Only Building Official Name: Permit No.: Date: Note 1.Indicate with an`x'project design plans,computations and specifications that you prepared or directly supervised.If`other'is chosen, provide a description.