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29-119 (5) 76 FOREST GLEN DR BP-2019-0474 GIs#: COMMONWEALTH OF MASSACHUSETTS MV:Block:29- 119 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:Deck BUILDING PERMIT Permit# BP-2019-0474 Proiect# JS-2019-000758 Est. Cost:$4700.00 Fee: $65.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: BRADFORD J MOREAU II 75408 Lot Size(sq. ft.): 12893.76 Owner: MARTIN JEAN M Zoning Applicant: BRADFORD J MOREAU II AT. 76 FOREST GLEN DR Applicant Address: Phone: Insurance: 9 HARLOW CLARK RD (413) 358-7946 HUNTINGTONMA01050 ISSUED ON:10/18/2018 0:00:00 TO PERFORM THE FOLLOWING WORK.-REMOVE EXSITING CONCRETE DECK AND REPLACE WITH WOOD DECK - SAME SIZE - 6X4'6 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: Qi 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: FeeTyne: Date Paid: Amount: Building 10/18/2018 0:00:00 $65.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2019-0474 APPLICANT/CONTACT PERSON E i ADF'ORD J MOREA' 11 ADDRESS/PHONE 9 HARLOW CLi:_1K RD HUNTINGTON (413)' 58-7946 PROPERTY LOCATION 76 FORES""GLE,' DR MAP 29 PARCEL 119 001 ZONE THM)SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Buildiny,Permit Filled out Fee Paid Typeof Construction: REMOVE EXSITING CO RET CK AND REPLACE WITH WOOD DECK- SAME SIZE-6X4'6 New Construction Non Structural interior renovations Addition to Existing Accesso1y Structure Buildinp,Plans Included: Owner/Statement or License 75408 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFQRMATION PRESENTED: Approved Additional permit§required(see below)11 s: PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Permit With Site Plan Major Project: Site Plan AND/OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance* Received&Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission Permit DPW Storm Water Management Demolition Delay Signature of Building Official Date Note:Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health,Conservation Commission,Department of public works and other applicable permit granting authorities. *Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact Office of Planning&Development for more information. f City of Northampton , R Building Department x A 212 Main Street Room 100 ,3 �2 Northampton, MA 01060 phone 413-587-1240ax �gg pp�� / FU Ei V E' APPLICATION TO CONSTRUCT,ALTER,RE AIR NOVATE ORDEN OLIS A ONE OR TWO FAMILY DWELLING SECTION 1 SITE INFORMATION PT.OF BUILDING 111 5 section to be completed by office 1.1 Property Address: NORTHAMPTON,MA 01060 Map v2Lot Unit; / mac' S " C� /l•/ i✓ Zone Ove€lay Dletrlct Elm St,district GB District SECTION 2 PROPERTY OWNERSHIPIAUTHORIZED AGENT 2.1 Owner of Record: Name(Print) CurrentM��ing Address: •, S' cJ ^sem.. s a.'n . , r zl� Telephone Sig ure 2.2 Authorized Agent: A�/�"� � z f2 ,vim G 4� r=✓'_S , t�,�l� Q`�,�'��L ; �`�_F�12/'C <L' Name(Print) Current Mailing Address: ✓ ��v , Signature Telephone SECTION 3 ESTIMATED CONSTRUCTION'COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building -7 0 (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) J 5. Fire Protection 6. Total=0 +2+3+4+5) i 7 J0 Check Number Ob This Section For Official'Use Only Building Permit Number: Date Issued:. Signature: Building Commissioner/inspector of Buildings Date EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department ... _..._ Lot Size Frontage _ _.. _.... ... _..... _._ ...._.. ..__. _.... Setbacks Front Side L.'__..---- R:!... -' L: ..... ..__ R Rear Building Height Bldg. Square Footage _, % Open Space Footage % (Lot area minus bldg&paved _. Parking) #of Parking Spaces Fill: volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DON'T KNOW Q YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW C) YES 0 IF YES: enter Book Page, and/or Document# B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW 0 YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained 0 , Date Issued: C. Do any signs exist on the property? YES NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES Q NO 0 _...._..__.._..__.._.._ ._ ... ...... IF YES, describe size, type and location E. Will the construction activity disturb(clearing, grading,excavation, or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. SECTION$-DESCRIPTION OF PROPOSED WORK(check all apolicabie} New House C] Addition ❑ Replacement Windows Alterations) ❑ Roofing ❑ Or Doors 0 Accessory Bldg. ❑ Demolition ❑ New Signs [I=1 Decks [IN Siding[Ql Other[Cl) Brief D cription of ProposeAl"; �X, f r �) Work: N." 'JJ !'a � k= h`lr t Mfr' L'I�'{ t� G Gt f� Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet _ oriM to iicstlirausst €.c€�rn�atete>�f® c ►in a. Use of building: One Family Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No I. Septic Tank City Sewer Private well City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner of the subject I, property hereby authorize to act on my behalf, in all matters relative to work authorized by this uilding permit application. Signature of Owner Date I S U 'xu;,'-1L'0 Z J/7 IV�ps as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. n ^�(- Print Name n Date SignOwner/Agent ature of SECTION8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: �2�! [.//—CJ��_"� yr �U/►�/�J �r"�` �J �) C/ Licenseumber iy ,7 4 � � Zz P Addr s Expiration Date Yl 79 Signatur � Telephone S R"ftbuyd Ham knorovOnskCo r. Not Applicable ❑ Company Name Registrption N tuber Address //77 Expiration to Telephone YJJ-1 `�� SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes....... ❑ No...... 15 r City of Northampton � Massachusetts :- 4 DEPARTMENT OF BUILDING INSPECTIONS \ 212 Main Street • Municipal Building Northampton, MA 01060x0 AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application The Office of Consumer Affairs and Business Regulation("OCABR")regulates the registration of contractors and subcontractors performing improvements or renovations on detached one to four family homes. Prior to performing work on such homes,a contractor must be registered as a Home Improvement Contractor("HIC"). M.G.L. Chapter 142A requires that the"reconstruction, alteration, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units....or to structures which are adjacent to such residence or building"be done by registered contractors. Note:If the homeowner has contracted with a corporation or LLC,that entity must be registered Type of Work:/eC dLA/17, /2/ZI� (e,t'—f-6 � tEst. Cost: t Address of Work: ;76' CL 0 A/ Date of Permit Application: /i�/ I hereby certify that: Registration is not required for the following reason(s): _Work excluded by law(explain): _Job under$1,000.00 Owner obtaining own permit(explain): Building not owner-occupied Other(specify): OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER M.G.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION. Signed under the penalties of perjury: I hereby apply for a building permit as the agent of the owner: Z�h y /J Da Contractor Nam HIC Registration No. OR: Notwithstanding the above notice, I hereby apply for a building permit as the owner of the above property: Date Owner Name and Signature City of Northampton Massachusetts cx ' DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Buildingy Northampton, MA 0106010 Massachusetts Residential Building Code Section 110.R5.1.2 Homeowner: Person (s) who own a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and/ or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Section 110.R5.1.3.1 Any homeowner performing work for which a building permit is required shall be exempt from the licensing provisions of 780 CMR 110.R5, provided that if a homeowner engages a person(s) for hire to do such work, then such homeowner shall act as supervisor. Such homeowner shall submit to the Building Official, on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, you may be liable for person(s) you hire to perform work for you under this permit. City of Northampton Massachusetts DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street •Municipal Building y.w .,.< Northampton, MA 01060 Debris 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. The debris from construction work being performed at: Cl_e/,j Of- (Please print house number and street name) Is to be disposed of at: (Please print name and location of facility) Or will be disposed of in a dumpster onsite rented or leased from: r (Company Name and Address) Sign ure rmit Aplican pt or Owner Date If, for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the Building Department as to the location where the debris will be disposed. The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 Boston, MA 02114-2017 www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print LeEibly Name(Business/Organization/Individual): �;G ��. Address:—9 Q1'1��'y r 0�� 1� rlCl f�'p , City/State/Zip: G/ *, �i .r . Phone#: Are you an employer?Check the appropriate box: Type of project(required): LE J I am a employer with employees(full and/or part-time).* 7. New construction 2.O I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.F�I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10 Q Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs 6.JZese sub-contractors have employees and have workers'comp.insurance? 7 r/ We are a corporation and its officers have exercised their right of exemption per MGL c. 14.00ther 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certif 7 v under the pains and penalties of perjury that the information provided above is true and correct Si nature: ` �JY r/?� (' ? � Date: / � Phone#: -�- 7 x� '✓5c7p— 1791/�'' Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: r Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely, by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston,MA 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 02-23-15 www.mass.gov/dia Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However,the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply your insurance company's name,address and phone number along with a certificate of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required.Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number.In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary). A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture(i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street Boston, MA 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax#617-727-7749 www.mass.gov/dia Form Revised 02-23-15 AC0® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDNM) 10/02/2018 THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLYAND 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(les)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 Adina Edgett NAME: Webber&Grinnell PHONE (413)586-0111 FAX (413)586-6481 AIC No Ext): A/C No): 8 North King Street E-MAIL aedgett@webberandgrinnell.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC 8 Northampton MA 01060 INSURER A: Main Street America/MSA 29939 INSURED INSURER B; Commerce Insurance 34754 Bradford Builders,Inc. INSURER C Attn:Bradford Moreau INSURER D: 9 Harlo Clark Road INSURER E: Huntington MA 01050-9799 INSURER F: COVERAGES CERTIFICATE NUMBER: Exp 07/19 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. IY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MNWD CY F MM DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RFNTEI5 CLAIMS-MADE �OCCUR PREMISES Es occurrence $ 500,000 MED EXP(Any one person) $ 10,000 A MPT9550S 08/04/2018 08/04/2019 PERSONAL&ADV INJURY $ 1'000'000 GEN'LAGGREGATE LIMITAPPLIES PER* GENERAL AGGREGATE $ 2,000,000 POLICY ElPRO- LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea acddent ANY AUTO BODILY INJURY(Per person) $ B OWNED XSCHEDULED BCDR20 07/13/2018 07/13/2019 BODILY INJURY(Per accident) $ AUTOS ONLY X HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident Underinsured motorist $ 100,000 UMBRELLALIAB �V'„� ,��WREN '",•• OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ NIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached If more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN c/o Mike Houston ACCORDANCE WITH THE POLICY PROVISIONS. 43 Dickinson Dr AUTHORIZED REPRESENTATIVE Granville MA ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Office of Consumer Affairs and Business Regulation One Ashburton Place - Suite 1301 43: Boston, Massachusetts 02108 Home Improvement Contractor Registration z y F, u a Type: Corporation - Z r�++ fl w Registration: 170018 n o BRADFORD BUILDERS INC Expiration: 08/30/2019 sod 3 fA W 9 HARLO CLARK RD 2 0 _, w -a HUNTINGTON, MA 01050 Q�> � b o 3 Update Address and return card. 0 Q 3 SCA 1 0 20M•05/17 to O .l/rP T-/v!t!!)!%7C!'fYlll// l{./.�¢•r1C1'lY!llJPf�i Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR 1 N Registration valid for individual use only v TYPE:Corporation before the expiration date. If found return to: Registration Exciration Office of Consumer Affairs and Business Regulation 17001$ 08/30/2019 10 Park Plaza-Suite 5170 BRADFORD BUILDERS INC Boston,MA 02116 BRADFORD MOREAU 9 HARLO CLARK RD HUNTINGTON,MA 01050 Undersecretary Not valid without signature Office of of Consumer Affairs and Business Regulation One Ashburton Place - Suite 1301 Boston, Massachusetts 02108 Home Improvement Contractor Registration r, n y w Type: Corporation z 'n m a u, Registration: 170018 000 _ = BRADFORD BUILDERS INC n'0 a y o Expiration: 08/30/2019 Z°;;o U " ao 9 HARLO CLARK RD p �, a r HUNTINGTON, MA 01050 e� : 6 � w �v 66 � M O C Update Address and return card. O 3„ SCA 1 0 2OM-05/17 ' N � � ,7%v Z Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Corporation before the expiration date. H found return to: n; Reaistration Expiration Office of Consumer Affairs and Business Regulation W M 17001808/30/2019 10 Park Plaza-Suite 5170 K Boston,MA 02116 BRADFORD BUILDERS INC BRADFORD MOREAU 9 HARLO CLARK RD � - HUNTINGTON,MA 01050 Undersecretary Not valid without signature { i, I i �r i a f ! P EE arc customizable system l � � O b O 0,,6 C C ' � r v ' 4 6 /]J or 0 W� p f 1 tt� '1 f A r k Lb i v it N, R' t ,tl i/,S � IAP- 7 � 1 q �J A 3 s 546 vIe.,Lq by Staples i t. .a. CSL #75408 Bradford Builders Inc. HIC #170018 9 Harlow Clark Rd. Huntington MA Jean Martin 76 Forest Glen Dr. Florence MA Scope of work: - Bradford builders to pull a building permit for the said project. - Bradford builders to remove existing front deck and dispose of. - Bradford builders to construct a 6' wide by 4'6" deep front deck. - Bradford builders to construct the deck out of pressure-treated 2x6's - 2 x 6 joist hanger to be fastened with the Simpson tie nails - Outside band to be 2 x 8 P-T. - Bradford builders to put in 2 8" concrete sonatubes 4' deep. - Fastened with 1/2" x 12" anchor bolts to 4" x 4" post base. - Bradford builders to use trex transcend decking with a hidden fastener. - Railings to be white vinyl fastener with provided hardware. - Band for builders to wrap ban with Azek or similar products. - Bradford builders to construct new stairs with trex and code railings. - Bradford builders and Jean have decided to go with a concrete pad at the bottom of the stairs. This will be married into the bricks with a reasonable and customary way. - Bradford builders will install a piece of white coil stock around the base of the siding to help prevent animal issues. This does guarantee no mice. - Owner to supply power for the project. Total cost- $4700 Due when signing contract $3000 Due upon completion $1700 X t.li it Y) l' dCh.t,��' X Jean Ntartin Bradford Buil c. G16 ��j°