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31A-152 (5) BP-2022-0729 35 MBlock RD RD COMMONWEALTH OF MASSACHUSETTS Mot: 31 A-152-001 CITY OF NORTHAMPTON Permit: Alts Renovations Repair PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS • DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit # BP-2022-0729 PERMISSIONISHEREBYGRANTED TO: Project# RENOVATION Contractor: License: RENAISSANCE BUILDERS DBA Est. Cost: 2278I8 GILL BUILDING CORP 013302 Const.Class: Exp.Date:08/17/2023 • Use Group: Owner: BRESLOW STEVEN H &CARYN J BRAUSE Lot Size (sq.ft.) RENAISSANCE BUILDERS DBA GILL BUILDING Zoning: URB Applicant: CORP Applicant Address Phone: Insurance: PO BOX 272 (413)863-8316 MCC20020004972021 TURNERS FALLS, MA 01376 ISSUED ON:06/23/2022 TO PERFORM THE FOLLO WING WORK: INTERIOR AND EXTERIOR RENOVATIONS 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: 1 .• . 6 Fees Paid: $1,482.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner RECEIVED The Commonwealth of Massachusetts JUN 1 r Board of Building Regulations and Standar(s 20 FO r.VI MUNICI' •LIT ' Massachusetts State Building Code, 780 C R DEpT ,_ OF f3 l ULDINC 1 Building Permit Application To Construct, Repair,Renova - i .1.!-'f i Miro r 20 One-or Two-Family Dwelling - ' This Section For Official Use Only Building Permit Number:ISp• a.7—• 7�9 Date Applied: 44.)'rL� s A G-23-20z2 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers 35 Maynard Road 31 A-152-001 1.1 a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: **no change** **no change** Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) **no change** Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public ID Private ID Municipal Outside Flood Zone? Municipal❑ On site disposal system ❑ Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Steven Breslow& Caryn Brause Northampton, MA 01060 Name(Print) City,State,ZIP 35 Maynard Road 413-320-6261 cjbrause@yahoo.com No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied IX Repairs(s) 14 Alteration(s) IX Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed work2:interior and exterior renovations per attached plans and work list. SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ ❑ Standard City/Town Application Fee ❑Total Project Cost' (Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Suppression) Total All Fees: P. Check NcL4A 0 Check Amount l) Cash Amount: 6.Total Project Cost: $ 227,818.00 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-013302 8/17/2023 Stephen Greenwald License Number Expiration Date Name of CSL Holder U P.O. Box 272 List CSL Type(see below) No.and Street Type Description Turners Falls, MA 01376 U Unrestricted(Buildings up to 35,000 cu.ft.) R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 413-863-8316 info@renbuild.net i Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) Stephen Greenwald 199409 8/23/2022 HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name P.O. Box 272 info@renbuild.net No.and Street Email address Turners Falls, MA 01376 413-863-8316 City/Town,State,ZIP Telephone SECTION 6: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 l$[ No 0 , SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize to act on my behalf,in all matters relative to work authorized by this building permit application. **see attached Owner authorization** Print Owner's Name(Electronic Signature) Date SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in thi pplication is true and accurate to the best of my knowledge and understanding. llao�,ie 6/15/2022 Print Owner's or Authorize Age Narhe(Electronic Signature) Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq. ft.) Habitable room count Number of fireplaces_ Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" RENAISSANCE BUILDERS cr"-'1/4 PO BOX 272,TURNERS FALLS,MA 01376,413.863.8316 INFO@RENBUILD.NET,WWW.RENBUILD.NET May 24, 2022 (updated 6/15/2022) Caryn Brause and Steven Breslow 35 Maynard Road Northampton, MA 01060 Proposal for Interior and Exterior Renovations to Home at Above Address Per Owner Supplied Plans and Specifications Dated April 4, 2022, and Whetstone Engineering SK 1 through SK 4. Revised from Proposal dated February 8th and additional revisions to lighting and kitchen. Scope to include the following per owner provided outline: • Renovation of kitchen and dining room. • Structural changes per Whetstone Engineering drawings. • Replacement of roofing. • Additional lighting and painting throughout the house. • Plaster and drywall repairs and replacement in work areas. • Insulation upgrades. • Limited window and door replacement. • Renovation to powder room and mudroom on first floor. 1000 GENERAL CONDITIONS 1020 Permits A. Supply all building permits as required. 1300 Project Management A. Provide copy of current Construction Supervisor's License. B. Provide shop drawings, samples, color choices, and/or selection charts as needed for Owner's approval. C. Coordinate operations under different sections that are dependent on each other for proper installation and operation. D. Notify Owner as necessary when scheduled work will impact occupied portions of the premises. Brause Proposal Page 2 1310 Supervision A. Provide supervision at all phases of construction performed or subcontracted by Renaissance Builders. 1400 Warranty A. Supply certificate of liability (minimum $ 2 million) and Workers Compensation Insurance. B. All work performed or subcontracted by Renaissance Builders to be guaranteed for one year. 1520 Temporary Facilities A. Provide portable toilet for workers. 1530 Temporary Protection A. Construct temporary dust-proof partition to separate work areas from surrounding areas. B. Provide floor and dust protection to work areas and provide a walkway to and from work areas. C. Provide protection against the spread of lead dust to surrounding work areas. D. Protect completed work in progress to ensure protection from damage or deterioration until substantial completion of project. 1730 Cleanup & Trash Disposal A. Clean up all debris and leave the job site broom clean at completion of all work. B. Legally dispose of all debris. C. Vacuum all affected areas with vacuum equipped with HEPA (High Efficiency Particulate Air) filter at completion of repairs. D. Clean interior of house prior to move in. Includes: a. Wash interior of all windows. b. Vacuum and/or damp mop all floors. c. Wipe down all cabinet interiors, countertops, bath fixtures, woodwork, and shelving. 1950 Owner Responsibilities A. Any charges by utility companies. B. Cost of electricity and water during construction. C. Provide written specifications (available from dealer) for all appliances. D. Provide the following for installation by contractor: kitchen cabinets, windows and exterior doors, plumbing fixtures, bath accessories, and closet systems. E. All other phases not specifically outlined in this Proposal. 2000 SITE WORK 2220 Demolition, Exterior A. Remove and legally dispose of existing roof shingles on all roofs. B. Remove and legally dispose of existing double coverage roofing on office roof. Renaissance Builders, PO Box 272, Turners Falls, MA 01376 License#013302, Registration#106490 6/15/2022 Brause Proposal Page 3 C. Provide protection from adverse weather conditions, as needed, for any portions of work exposed during the course of work. D. Saw cut siding per owner's plans for new flashing. E. Remove existing windows in the following locations: south wall primary bedroom, west wall kitchen, north wall kitchen, and mudroom. Includes removing entire frame in preparation for installation of new constructions units. 2225 Demolition, Interior A. All demolition as shown on plans. B. Remove entire existing ceiling in playroom and mudroom. C. Remove existing walls shown on demolition plan in kitchen/dining room, chimney, and wall in closet to access chimney. D. Cut openings as necessary for new plumbing and electrical work. 4000 MASONRY 4210 Brick A. Repair and replace brick on steps and sides of front entry stair. B. Remove two existing brick stairs at side entry and replace with Bluestone treads. C. Repoint steps and landing and replace all damaged brick on landing. D. Saw cut and tooth out brick at new door to pool. E. Resize kitchen window using salvaged brick. 6000 WOOD & PLASTICS 6105 Carrying Timber & Sill Plates A. Install Lally column per Whetstone Engineering plans. B. All Lally columns to have Springfield plates at tops and bottoms of columns. C. Install two new beams in ceilings per Whetstone Engineering plans. D. Sister rafters per Whetstone drawings. E. Install rafter ties per Whetstone drawings. 6110 Framing, Floors & Ceilings A. Prep all ceilings opened during the course of renovations for new finishes. B. Install CDX underlayment in kitchen in thickness required for new wood flooring to meet existing wood floors. 6120 Framing, Walls A. Frame new opening in west wall for new entry door. B. Construct all new walls and openings as shown on drawings. 6220 Casing & Base A. Window and door casings to be paint grade poplar and match existing profiles as closely as possible. B. Base moulding to be paint grade poplar and match existing profiles. C. Install picture rail to match existing on all new walls. Renaissance Builders, PO Box 272, Turners Falls, MA 01376 License#013302, Registration#106490 6/15/2022 Brause Proposal Page 4 6405 Cabinets, Premanufactured A. Owner to provide kitchen cabinets and hardware. Owner responsible for field measurements prior to ordering cabinets and for cabinet design. B. Install all cabinets and hardware. 6410 Custom Shelving & Casework A. Supply and install custom casework and shelving, per allowance. B. Shelves in kitchen and bench in entry and mudroom. 6415 Countertops A. Supply and install solid surface kitchen countertops, per allowance. 6720 Exterior Trim A. Install new trim where siding has been cut back for new roof flashing. B. All new exterior trim to be either Boral fly ash composite or Cellular PVC. C. Repair all damaged windowsills using structural epoxy. D. Install new exterior trim around new window in primary bedroom and new doors. E. Replace miscellaneous trim not connected to window door replacement or roofing work. F. All work in this section to be per allowance for labor and materials. 6800 Porch & Deck Framing A. Floor joists on deck to be 2" x 6" pressure treated, 16" o.c. B. New deck at west entry door to be 3'-6" in depth and full width between mudroom and screen porch. C. Stairs to be boxed construction and full width. 6810 Porch & Deck Finish A. Deck and treads to be 5/4" x 6" clear red cedar decking. B. All decking and treads to be installed using concealed fasteners. C. All risers to be red cedar. 7000 THERMAL & MOISTURE PROTECTION 7200 Insulation, Vapor Barrier A. Playroom ceiling and roof to have 7" of sprayed in place closed cell polyurethane foam (R-51). B. Insulate all exterior walls opened during the course of renovation with 3" of closed cell foam. C. Install spray foam insulation around perimeter of all new exterior doors and windows. D. Seal penetrations between floors with Thermafiber fire stopping or fire rated silicone. 7300 Roofing A. Install 8" aluminum drip edge along all rakes and eaves. B. Install Grace Ice & Water Shield along first 6' of all eaves. C. Install Grace Ice & Water Shield on all roofs with a slope under 4/12 over heated areas. D. Install Palisades shingle underlayment on remainder of roof. Renaissance Builders, PO Box 272, Turners Falls, MA 01376 License#013302, Registration#106490 6/15/2022 Brause Proposal Page 5 E. Install lead counter flashing and aluminum step flashing around all chimneys. F. Install aluminum step flashing where roofing meets side wall of building. G. Install continuous ridge vent. H. Install architectural shingles, LANDMARK Pro Series, by CertainTeed. I. Install 60 Mil EPDM roofing fully adhered to office roof. 8000 DOORS & WINDOW 8100 Doors, Exterior A. Exterior door and sidelight to be as shown on plans. B. Owner to supply two (2) entry doors and one (1) screen door, including all hardware. C. Exterior door to have bituthene membrane installed at sill down to bottom of joist and 6" higher than door. D. Set exterior door in bed of acoustical sealant. E. Shim door at all hinges and all corners. All shims to be installed prior to insulation. 8500 Windows A. Install windows supplied by owner in the following locations: Kitchen, mudroom, office, and south wall of primary bedroom. 9000 FINISHES 9200 Sheetrock & Plaster A. New walls and ceilings and demoed walls and ceilings to have 1/2" drywall. B. Fill all voids and holes using Durabond dry mixed compound. C. All joint tape to be applied using Durabond dry mixed compound. D. Bath walls and ceilings to have moisture resistant drywall. E. Finish all drywall with three coats of joint compound, sanded smooth. F. Patch all areas affected by renovation and leave ready for painting. 9300 Tile A. Install ceramic tile back splash, per allowance for labor and materials. 9640 Wood Flooring A. Install white oak hardwood floor covering, per allowance, sanded and coated with three coats of oil-based polyurethane in the kitchen. 9650 Sheet Flooring A. Install Marmoleum flooring, on top of/4" Ultraply underlayment, in the powder room and mudroom. 9690 Floor Finish & Restoration A. Sand existing floor to the point of removing all existing finish all floors on first floor. B. Finish flooring with three (3) coats of polyurethane, semigloss/satin finish. 9910 Paint, Exterior A. All exterior trim to receive two coats Benjamin Moore, Sherwin Williams, or equivalent best quality paint. Renaissance Builders, PO Box 272, Turners Falls, MA 01376 License#013302, Registration#106490 6/15/2022 Brause Proposal Page 6 9920 Paint, Interior A. Fill all nail holes with non-shrink putty. B. All new interior walls and ceilings to receive one coat of Benjamin Moore Fresh Start® MoorWhite®, Sherwin Williams, or equivalent primer sealer. C. Interior walls to receive two coats of Benjamin Moore, Sherwin William, or equivalent flat acrylic paint. D. Interior ceilings to receive two coats of Benjamin Moore, Sherwin Williams, or equivalent ceiling paint. All ceilings to be the same color. E. All walls and ceilings in affected area to be painted corner to corner. F. Standing and running trim, door and window casings, millwork, and interior doors each to receive a total of three coats of Benjamin Moore, Sherwin Williams, or equivalent latex paint. 15000 MECHANICAL 15400 Plumbing A. Install water line connection for ice maker in refrigerator. B. Install one (1) dishwasher hook-up. C. Remove and reset sink in powder room. D. Remove and install new toilet in powder room. E. Install Owner-supplied kitchen sink and faucet. F. All water piping to be copper or cross-linked polyethylene tubing. G. All sewer and drains to be ABS plastic. 15800 Ventilation Ducts & Fans A. Install venting for new kitchen exhaust hood supplied by owner. 16000 ELECTRICAL 16100 Install lighting per revised plan dated 4/26/22 A. New switches per plan minus the existing to remain. a. 20-amp circuits for new exhaust hood and kitchen receptacles. b. 50-amp circuit for range. c. 50-amp circuit for wall oven and microwave. d. Relocate existing switches in kitchen. e. Install one (1) new sconce in powder room. Fixtures to be provided by Owner. f. Fixture type P and CM are by Owner. g. Code required arc fault and GFI breakers for new circuits. END WORK LIST Renaissance Builders, PO Box 272, Turners Falls, MA 01376 License#013302, Registration#106490 6/15/2022 7NY RENAISSANCE J- BUILDERS PO BOX 272,TURNERS FALLS,MA 01376,413.863.8316 INFO@RENBUILD.NET, We, Carvn Bra use & Steven Breslow, certify that we are the Authorized Representatives of the property located at 35 Maynard Road, Northampton, MA. We hereby authorize Stephen Greenwald of Renaissance Builders, 390 Main Road, Gill, MA 01376 to submit a building permit application on our behalf for the interior and exterior renovations to home. We agree to conform to all applicable laws of the town and state, and we believe the work proposed to be in compliance with all zoning regulations and the Massachusetts State Building Code 780CMR. Signature of Authorized Representative: Printed Name: Caryn Brause Date: June 16, 2p22 Signature of Authorized Representative: Printed Name: Steven Breslow Date: June 16, 2022 The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations Lafayette City Center 2 Avenue de Lafayette, Boston,MA 02111-1750 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information - Please Print Legibly Name (Business/Organization/Individual):Renaissance Builders Address:P.O. Box 272 City/State/Zip:Turners Falls, MA 01376 Phone #:413-863-8316 Are you an employer?Check the appropriate box: Type of project(required): 1.El I am a employer with 24 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. El New construction 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 workingfor me in anycapacity. employees and have workers' P h' 9. ❑Building addition [No workers' comp. insurance comp. insurance.: required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other 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. tContractors 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:AIM Mutual Insurance Co. Policy#or Self-ins. Lic. #:MCC20020004972022A Expiration Date:08/01/2022 Job Site Address: 35 Maynard Road City/State/Zip:Northampton MA I 0\0 toO 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$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 may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby ce Y under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: 6/15/2022 Phone#: 413-863-8316 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(check one): 11=IBoard of Health 20 Building Department 31:1City/Town Clerk 4.0 Electrical Inspector 50"lumbing Inspector 6.❑Other Contact Person: Phone#: A`R 0® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 6/15/2022 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 Andrea Feeley,CISR NAME: Webber&Grinnell PHO No Ert): (413)586-0111 Fn/C,No): (413)586-6481 8 North King Street E-MAIL afeeley@webberandgrinnell.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC N Northampton MA 01060 INSURER A: Arbella Protection 41360 INSURED INSURER B: MA Employers/A.I.M. 12886 Gill Building Corporation INSURER C: DBA:Renaissance Builders INSURER D: PO Box 272 INSURER E: Turners Falls MA 01376 INSURER F: COVERAGES CERTIFICATE NUMBER: Exp 8/2022 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 TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDD/VYYY) (MMIDDIYYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1'000'000 DAMAGE RENTED CLAIMS-MADE X1 OCCUR PREMISESO(Ea occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 A 8500066134 08/01/2021 08/01/2022 PERSONAL&AOV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 _POLICY X JEC07 LOC PRODUCTS-COMP/OPAGG $ 2,000,000 _ OTHER: $ AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) — ANY AUTO BODILY INJURY(Per person) $ A OWNED %,/ SCHEDULED 1020057016 08/01/2021 08/01/2022 BODILY INJURY(Per accident) $ AUTOS ONLY /' AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ X AUTOS ONLY X AUTOS ONLY (Per accident) , Underinsured motorist BI $ 250,000 UMBRELLA LIAB split limit 9,000,000 X X OCCUR EACH OCCURRENCE $ A EXCESS LIAB CLAIMS-MADE4620085703 08/01/2021 08/01/2022 AGGREGATE $ 9,000,000 DED X RETENTION $ 10,000 $ WORKERS COMPENSATION MUTE LIABILITY STATUTE ER Y/N 1 000 000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ , , B OFFICER/MEMBER EXCLUDED? N N/A MCC20020004972022A 01/01/2022 01/01/2023 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 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) CERTIFICATE HOLDER CANCELLATION Caryn Brause&Steven Breslow SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 35 Maynard Road THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Northampton, MA 01060 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AFFIDAVIT FOR DISPOSAL OF DEMOLITION DEBRIS Supplement to Permit Application As a result of the provisions of MGL c. 40, s54, I acknowledge that as a condition of the issuance of a 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, s150A. I certify that debris resulting from this demolition will be disposed of as listed below: Job Site Location: 35 Maynard Road, Northampton, MA 01060 Name of Permit Applicant: Renaissance Builders Disposal Facility: F& G Recycling Address of Facility: 15 Mullen Rd., Enfield,Ct 06082 IF SAID FACILITY IS OTHER THAN WHAT I HAVE LISTED, I CERTIFY THAT I WILL NOTIFY THE BUILDING OFFICIAL OF THE CORRECT LOCATION OF THE SOLID WASTE DISPOSAL FACILITY WITHIN TWO MONTHS OF THE DATE OF THIS APPLICATION. 6/15/2022 Signature of Applicant Date Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Construefi6A%LSpervisor CS-013302 E;jcpires: 08/17/2023 STEPHEN J GREENWALD if r _ PO BOX 272 TURNERS FALLS MA 01376 Commissioner exa ca f t7Cvn to- Construction Supervisor Unrestricted -Buildings of any use group which contain less than 35,000 cubic feet(991 cubic meters) of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For information about this license Call(617)7273200 or visit www.mass.gov/dpl RENAISSANCE 11BUILDERS PO BOX 272,TURNERS FALLS, MA 01376,413.863.8316 INFO@RENBUILD.NET, WWW.RENBUILD.NET June 16, 2022 Jonathan Flagg, Building Commissioner City of Northampton 212 Main Street Northampton, MA 01060 Jonathan, Enclosed is a permit application for interior and exterior renovations at 35 Maynard Road. Stephen is the project manager. His cell phone number is 772-9430 if you have questions or concerns. Also included is: ❑ A scope of the work ❑ An Owner Authorization signature page ❑ A Worker's Compensation Insurance Affidavit and current COI ❑ A Demolition Affidavit ❑ A copy of Stephen Greenwald's Construction Supervisor License ❑ Additional Supporting Documents (drawings) ❑ A check for $1,482.00 ($6.50 per $1,000 of job cost) Please call Stephen if you have any questions. Thank you, JG(/ /Ix( Madeline Spencer-Orrell Administrative Assistant madeline(a�renbuild.net