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35-061 (5) BP-2022-0943 918 RYAN RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 35-061-001 CITY OF NORTHAMPTON Permit: Exterior Res PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit # BP-2022-0943 PERMISSIONIS HEREBY GRANT I TO: Project# ROOF Contractor: License: Est. Cost: 18800 SEXTON ROOFING CO 99689 Const.Class: Exp.Date: 10/05/2023 Use Group: Owner: R. SLOAN, SHARON Lot Size (sq.ft.) Zoning: WSP Applicant: SEXTON ROOFING CO Applicant Address Phone: Insurance:, P O BOX 6327 (413)534-1234 7pjubog07898222 HOLYOKE, MA 01041 ISSUED ON:08/10/2022 TO PERFORM THE FOLLOWING WORK: STRIP AND RESHINGLE 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 VIOL TION OF ANY OF ITS RULES AND REGULATIONS. Signature: i J r• yg • 3'/ • 1 Ili Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner a• The Commonwealth of Massachusetts Board The City o Holyoke B ' ding t+rt•i f' r`"'`"�' of Building Regulations and Standards D artment is- -._G%y t i Massachusetts State Building Code,780 CMR 20 Korean Vete s Plaza � G _ 8 / Ro 0 tc..-.f f'. ? CO22 Building Permit Application To Construct, Holyoke, 01040 "°iiti` .= Repair, Renovate Or Demolish a One-or 413- 2 600 I/401 ma o,No rNsa�eT Two-Family Dwelling v.�.�, hol'.o1:� ,r M>r rri44 -0I MA Ili— IONS ON. This sSSec`ti n For Official Use 0 y ~--�. Building Permit Number: - A-A " Y"f .5 Date Applied: 4-,./$4...A15 1/ 8-10-z012 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Propertet/ry Address: 1.2 Assessors Map&Parcel Numb s 1.I a Is this an accepted street?yes no Map anber Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) i 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 0 Private 0 Zone: — Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1,\,Qw`11er'o�ecorY(0 4") Mli46 % t' I Name( nnt) [] City,State,ZIP VW q,Cf /t4J4-0 Ca c7-flc-1 r7s - SAAR/5W ep- ).C,. .. No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK(check all that apply) New Construction 0 Existing Building l/15wner-Occupied Wit—Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg.0 Number of Units / Other 0 Specify: 7qv.-z Brief Desc ' lion of Proposed Wor 2:_ / /7 / P-e-,lQ� / ll�� rick o >.etr s4 e ,4 /Zoe SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials)_ 1.Building $ Building Permit Fee:$ Fee schedule can be found on the Building Department page t 2.Electrical $ 3.Plumbing $ 4.Mechanical (HVAC) $ Date Received 5.Mechanical (Fire $ Suppression) Check No 341Check Amount:* Cash Amount: 6.Total Project Cost: $ KO 0 Paid in Full 0 Outstanding Balance Due: i0 SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) t Y2re 11 ie,t 1 )i-) License Number i nn Date Name of CSL Holder ^� �r _T;, ?o SOK �1, 7 List('SI Type(seebelow) 7 e_ �i No.and Street[ p �] ) 1� Type Description 1 I U J eT)C_. f /I g 0/6 /f 1.1 Unrest-kith(Buildings up to 35,O00 cu.ft) R Restricted l&2 Family Dwelling Cityrr' State,ZIP M Mammy RC _Roofing Covering WS Window and Siding SF Solid Foes Burning Appliances I Insafation Telephone Email address D Demolition ,r._ 5_2 Registered Home Improvement Contractor(HIC) r p 1} r E l r 1 y. !h 7 fF &X i? /7G%th fia ind O/O /2 7I�JI'- HICRegisuationSlnmber Eapimtrouxf e" HIC Co any Name or HECjtegstranr Name j r� r..x f�3 7 ,3 -01-if-61 hr `m(ill,027 No.and Street F Agoif address 4/aeh e, 1.1719 G)/ i3// 4/3-53 -1 q City JT wn,State,LIP Telephone SECTION.+;:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(IMM-G.L c.152-§25C(6)) Workers Corupencation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the drriaf of the Issuance of the building permit. Signed Affidavit Attached? Yes ' 'Eie* No D SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN • OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the onlmject property,hereby anthari=x D� �f}�j Ji1JG 21 /J �( z to act on my behalf,in all matters relative to work authorized by this butldir etmit application_-, Conireul.r oe1.gd Ff/ Print Owner's Name(Electronictur Signae) Date SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION By entering my norm-below,I hereby attest under the pains and penalties of perjury that all of the information contained in this plication s true and accurate to the best of my knowledge and understand MISTBE SIGNED by Owner or Authorized Agent Date NOTES: 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.727ti have access to the arbitration program or guaranty fund under M.G.L.c.142A_Other important information on the IBC Program can be found at w u1r.a ac,s.novfoca Information on the Construction Supervisor License can be found at www.mass.govfdps 2. When substantial work is planned,provide the information below: Total floor area(sq_f.) (ncluding 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 ofhalf/baths Type of heating system Number of deckcs/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cosy' City of Northampton p.,N.Allf f :.,'" ; Massachusetts ,s S,c'<< +'1J - )c. r i d Il i A. DEPARTMENTDEPARTMENT OF BUILDING INSPECTIONS S 10.0, ; '�' s vb 212 Main Street • Municipal Building l Northampton, MA 0106D '�SMh, �\�\D CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: Location of Facility: '6e iii in 5/ icil The debris will be transported by: Name of Hauler: 4-5,(:«e,- -J q. .,, 0 t ✓A--ir t4---)✓ f"c 4- S Signature of Applicant: Date: r/Z�7Z Proposal SEXTON ROOFING AND SIDING NC 44. Alf Lajr© P.O.Box 27 ‘110' a „ Holyoke,MA 01041 Setting the Standard — 1 44 la rya': 411,Any ANNE mom NAIM-fa, / AM"AMR WPM IOW p.413334.1234 f.413.539.9906 MA MC 118239 _ sextonroofing@hotimail.com SMUTTED TO Sharoa Slo j PHONE 617-894-1119S DATE ‘122/22 STREET 918 Ryan Rd EMAIL daanstaiiiyahanant CITY,STATE,ZIP Nortialspiali Ilia. ma& SEXTON ROOFING HER SUBMITS SPEaFICATIONS AND ESTIMATES FOR:ROUSE ROO (Add$.5400.00 for garag ) ( eti I) Ship and remove existing shingles and dispose of in proper landfill. 2) Inspect roofing deck and replace as needed @$105.00 per sheet. 3) Install new metal edging to rakes and eaves of roof.(white/brown) 4) Install ice and water shield on eaves(6'),vent stacks,in valleys,chimney, and at intersecting roofs. 5) Install synthetic roofing underlayment on remainder of roof. 6) Install new flanges over existing vent stacks. 7) Install starter shingles on eaves and rakes of roof. 8) Install IKO Architectural style roofing shingles as per manufacturers'specifications. 9) Install new cap over ridge vent. 10) Rafael chimney as needed @$400.00 11)Supply manufactures Lifetime warranty and SRC 5 yr.workman**warranty. ATTENTION HONIEOwNERS:PLEASE COVER ALL PERSONAL BEtimiNICS IN THE ATTIC,GARAGE,OR STORAGE MAW DUE TO POSSIBLE ROOFING DEBRIS OR DUST COMING'THROUGH CRACKS OF WOOD DECKING. sexioN ROOFING SHAU.AEPLY RIR ALL PERMITS FbRPIKHECE We Propose hereby to furnish material and labor-comPlete litetirtitruter IWO title above speqificaj r tbe sum of Twehre Thousand Eight Hundred DOLLARS IS12,800..00) PAY TO BE MADE AS IFOLOWS: due in full upon completion etttli ‘00/0 416. 41. Department of Industrial Accidents ^ 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/Organi7ation/Individual):Sexton Roofing&Siding Inc Address:P.O. Box 6327 City/State/Zip:Holyoke, Ma. 01041 Phone#:413-534-1234 Are you an employer?Check the appropriate box: Type of project(required): I.❑ I am a employer with 4. © I am a general contractor and I have hired the sab-contractors-tocs employees(full and/or part-time). 6. El New construction listed on the attached sheet. 7. El Remodeling El I am a sole proprietor or partner- ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' 9. Building addition [No workers' comp.insurance comp.insurance.t 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.❑Plumbing repairs or additions myself [No workers'comp. right of exemption per MGL l2.11I Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.0 Other comp.insurance required.] .ny applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :ontractnrs that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have nployees. If the sub-contractors have employees,they must provide their workers'comp.policy number. am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site [formation. isurance Company Name:Travelers Property Cas Co Of Am obey#or Self-ins.Lic.#:7PJUB0007898227 Expiration Date:06/4/23 )b Site Address: 'J ( 4/ City/State/Zip: it.)-6 1-7 l-1 ` • ttach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). allure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a ne 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 f up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of tvestigations of the DIA for insurance coverage verification. do hereby certify under the ' ins and penalties of perjury that the information provided above is true and correct: gnature: Date: ( 2 7 `1— hone#: ��Y / / z 3 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): 1❑Board of Health 20 Building Department 31:City/Town Clerk 4.0 Electrical Inspector 5Elumbing Inspector 6.0Other Contact Person: Phone#: f • AC® CERTIFICATE OF LIABILITY INSURANCE DATE `1111/0 ) 06/07/2022 THIS CERTIFICATE IS ISSUED AS A MAI itif OF INFORNIATEON 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 1NSURER(S), AUTHORIZED • REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT: If the certificate holder is an AQDIT1ONAL IAtSURED,the poiicy(res)nemt 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 tuut Kathi Hutchinson ORMSBY INSURANCE AGENCY uPHONE uc,Niz E (413)737 03 •MC, IN* . E-MAIL UtthinsOn nszor1 - ADDDDkh RESS: ��� P 0 BOX 718 aAC NAM* WEST SPRINGFIELD MA 01090 IAA: TRAVELERS PROPERTY CAS CO OF AM 25674 INSURED INSURER s, SEXTON ROOFING&SIDING INC INSURERC: INSURER 13 PO BOX 6327 INSURER E HOLYOKE MA 01041 INSURER COVERAGES CERTIFICATE NUMBER: 782111 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED Ti)THE INSURED D NAMED ABOVE FOR THE POLICY PERIOD INDICA I HI NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PEttIAIN,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. IF1SR .AnnL'Q�FF POLICY EFFF POLICY EXP LTR TYPE OFI1SURANCE pn MAID D i POLICY Nat A Yrfl I MIS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 5 DAMAGE TO RENTED CLAMS-MADE OCCUR PREMISES(Ea o®®o) $ Nam (Aey am dean) 15 i NIA PERSONAL S ADV INJURY I5 GEM_AGGREGATEUNIT APPLIESt it GENERALAGGREGATE S POLICY I I.>ECT E LOC 'PRODUCTS- AG OTHER: AUTOMOBILE i„LABILITY cOMBRIED SINGLE LIMIT e (Ea act) ANY AUTO BODILY NARY(Perperso.N) $ ALL OWNED SCHEDULED ED NiAA BCDNLY IN.IURY(Per aresal 5 NONALILOS PROPERTY DAAGE HIRED AUTOS AUTOS M_ (Pe accident) S UMBRELLA LIAB OCCUR EACI-IOC S EXCESS LAB CLAIMS-MADE NIA AGGREGATE I S DED RETENTION 5 S WORKERS COWPEMSA1 SI X I PER ER ff STATURE on AND EMPLOYERS LIABILITY Y r N EL SUCH ACCIDENT S 1,000,000 A o EXiLD NRAt MA NIA 7P,IUBOG0789r1222 06104/2022 06iO4/2023 (Mandatory ELD AQ-EA EMPLOYEE 5 1,000,000 IR yes,ci aibe under DESCRIPTION of OPERATIONS bear EL DISEASE.-POLICY LUNT 5 1,000,000 I WA DESCRIPTION OF OPERATIONS ILOR'ATIONSIVBar1ES 4ACCIRDlie'),AblitianalRates Schulman,may l:allacbei 4mespaca ism Workers'Compensation benefits will be paid to Massachusetts employees only_Ptsstait to Endo' e1Irtsrt WC 20 03 06 Brno authoritsithon s given to pay claims for benefits to employoc in states other than Massachusetts if the insured hires,or has hired those employees outside of MassaCtrusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(untess the expeatiOn date on the above policy precedes the issue date of this certificate of Insurance) The stair F of this coverage can be D KA Lib-Pied daly by accessing the Proof of Coverage-Coeerage Verification Search tool at www.mass.govilwdAvoricers-compensaticrulrivestigations,. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES aE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL L BE DELIVERED IN ACCORDANCE TRUTH THE POLICY PROVES t AUTHOREED REPRESENTATIVE MA 01040 Daniel M.Clpwfey C?CU,Vice President—Residual Market—WCRIBMA ©1988-Z014 ACORD CORPORA7iON. All rights reserved. ernan 7S r7n1n/oil TI.e Anion..oee.es i Ira.... .-a rebrwi lec e.+eremel a eel Ar iRn • SEXTO-2 OP ID: KH ACOROr CERTIFICATE OF LIABILITY INSURANCE ATE,MMIDO/YYYII 06/30/2022 THIS CERTIFICATE 1S ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATES 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( ), 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 413-737-0300 I COONTE CT Eric Dembinske Ormsby Insurance Agency Inc. PHONE 413-737-0300 FAX 413-737-0617 698 Westfield St PO Box 718 (NC,No,EA: (A/C,No): West Springfield,MA 01090 E-MAIL edembinske@ormsbyins.com Eric Dembinske INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Northfield Insurance Company SURED INSURER B:Progressive 24260 sNexton Roofing&Siding,Inc. PO Box 6327 INSURER C: Holyoke,MA 01041 I INSURER D: 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 TYPE OF INSURANCE �OOL SUBR POLICY NUMBER M/OPOLICY EFF POLICY OM UMRS LTR Ifi SD WYD IMD/YYYY) (MM/DO/YYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S -1,000,000 CLAIMS-MADE X OCCUR WS45073 06/25/2022 06/25/2023 pREMISES(Ea ooc�u D ncel S • 100,000 MED EXP(Any one person) S 5,000 PERSONAL&ADV INJURY S 1'000'000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 X POLICY PE° LOC PRODUCTS-COMPIOP AGG j 2,000,000 B OTHER: COMBINED SINGLE LIMIT $ 1,000,000 AUTOMOBILE LIABILITY (Ea accidenn _ ANY AUTO 04434955-0 05/15/2022 05/15/2023 BODILY INJURY(Per person) J — AUTOS ONLY OWNED X AUTOS SCHEDULED BODILY INJURY(Per accident) 4 _ X HIRED ONLY X NONAUTO-OS WNEDONLY (Per PROPERTY DAMAGE AUTOS ) UMBRELLA LIAB OCCUR I EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE j AGGREGATE DED RETENTION S 1 WORKERS COMPENSATION PER OTH- AND EMPLOYERS' ABIUTY I STATUTE I LI ER ANY PROPRIETOR/PARTNER/EXECUTIVE YIN TO BE ISSUED SEPARATELY EL EACH ACCIDENT OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) EL DISEASE-EA EMPLOYEE S If yes,describe under DESCRIPTION OF OPERATIONS below ,E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is requlred) roofing&siding contractor • CERTIFICATE HOLDER CANCELLATION NONE-01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEUVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTFBJR'REO REPRESENTATIVE _ I ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. • ` ACOR ® CERTIFICATE OF LIABILITY INSURANCEATE`MMiDD,YYYY' 06/17/2022 THISCERTIFICATE 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(Sj, 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 NAME: Karina Silva MAYFLOWER INSURANCE GROUP INC Pq/HONEO, o,; (774)773-9702 FAX eok E-M AIL karina@mayflowerinsurance.com 2 Court St Unit B INSURER(S)AFFORDING COVERAGE -- NAIC# Plymouth MA 02360 INSURER A: HARTFORD UNDERWRITERS INS CO •30104 INSURED INSURER B: --.. MNP CONSTRUCTION INC INSURER C: INSURER D: 76 GROVE ST APT 1 INSURER E: MILFORD MA 01757 INSURERF: COVERAGES CERTIFICATE NUMBER: 785876 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 TYPE OF INSURANCE SUBRPOLICY NUMBER (MMIDDPOLICY MNO N50 LTR INSD YtIW NYYYY) (MD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE . $ DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES(Ea occurrence) MED EXP(Any one person) N/A PERSONAL&ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG OTHER COMBINED SINGLE LIMIT AUTVMOefLELWBR-fTY � (Ea accident) ANY AUTO BODILY INJURY(Per person) OWNED SCHEDULED AUTOS ONLY AUTOS N/A .BODILY INJURY(Per accident)- HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) UMBRELLA LIAR _ OCCUR EACH OCCURRENCE EXCESS LAB CLAIMS-MADE N/A AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION - x PERE TUTS • ER_ AND EMPLOYERS'UABIUTY Y IN ANYPROPRIETORPARTNER/EXECUTIVE EL.EACH ACCIDENT $ 1,000,000 A OFFICER/MEMBEREXCLUDED? I Nod NIA PEA 6560U86R43531322 06/08/2022 06/08/2023 E.L DISEASE-EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes,describe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY UMfT $ 1,000,000 N/A DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/Iwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN SEXTON ROOFING & SIDING INC ACCORDANCE WITH THE POLICY PROVISIONS, 102 PINE ST AUTHORIZED REPRESENTATIVE Holyoke MA 01040 Daniel M.Cro f y,CPCU,Vice President—Residual Marlet—WCRIBMA I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD CLentlk DATE CERTIFICATE OF LIABILITY INSURANCE 113/21/2022 THIS CERTIFICATE 15 ISSUED AS A MATTER.OF INFORMATION INFORMATION ONLY AND CONFERS NO RIGHT UPON.THE CERTIFICATE HOLDER.THIS CERTi ICATE DOES NOT AFFIRMATIVELYOR'NEGATIVE_YAYEllD,EXIEiD OR:ALTEt TT 'COVERAGE AFFORDED BYTHE'POLICIES BELOW_THIS CERTIFICATE OFTNSURANCE DOES NOT CONSTI UTEACONTRACTBEIWEFNTHE'ISSUINGINSURER(();AUTHORITD REPRESENTATIVE OR PRODU CER,AND.THE CERTIFICATE HOLDER. IMPORTANT_tithe certificate holder is ae'ADOTIIONAL:INSURED,the policy(ies)mustbe endorsed.If SUBROGATION IS WAIVED W*r4 to the terms and conrsSosos of the policiVaistaiii.POliciiis mey, cheat a idw�..w,.L.A statementon thiscerhTic does not confer rights tDthe certificate holder in lieu of such endorsemeegs). PRODUCER CONTACTenne Camomto years- - . . PHONE •978:7 I—INSURANCE GROUP INC (NC.Ns.Eak • ElW_ 799 GORHAM ST Nx :' LOWELL,MA 01852 ICRIFEi(sIAFwPmNGCCNERAGE INSURED INSURER'A:;GENERAL STAR.INDEMNITY COM • INSURER S:-ARBELLA PROTECTION INSURANCE LDG HOME IMPROVEMENT INC •INSURERC: 18 SPRING ST FL1 INSURER D:TRAVELERS.PROPERTY.CAS CO OF AM . MILFORD, MA 01757 - IVSURER.E:.• INSURER F: COVERAGES CERTIFICATE.NUMBER:000015. . ...REVISION.NUMBER: -. INDICATED_NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAK THE INSU RANCEAFFORDED BY THE POUCES.DESCRIBED HEREIN IS SUBJECT TO TALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES:LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS_ A83 ALUi SLUR POLICY EFF PCUCY EtP TR TYPE QF INSURANCE - WvD POLICY KA®2 (110 YYYn.. .•( Yyy» [LAPS A GENERAL m • E�or Ica $ 1p00,000m1 X SEJER.L UAszrr - PIIWGETORENr87 PREIRSEStoa,...ml $ 700,000J00 MED OW tA/a vA®1 a�.AheisauoE x I OCCUR $ ssaoow, IMA335923A 3/512022 3/5/2023 PERSONAL.1.AIN lft/LITI $ 1,400,000AD (WOEFUL AGGREGATE $ 2.000,00000 aa3rLwr,LaRESArE UNIT APPLIES PERAiaduacadm. OP P,AD hi $ mn_. 00AG piolict f PROJECT I IT LOC • B AnlrlrrO�ElalBln7 COMLNIn carer lbw $ 100d000.00 SCOUT eaaant>�A� ANT AUTO $ , 1 I1-. AUTOS arPaa 1020096012 4/132021 4/132022 P1(POLr west(Pe s�d.q $ �poa o0 -NORO PAED t r rY IY +GE l MIMOS JAU OS p.�n $ 100,000�0.• IC MBRE„A LIAR ( o, w 6.O,occar+�itcE ,ArarsIFRAIE DEL RETENNONS f3COMPENSATION A1UmORY DotPLarBLT't]�RTRN LEatTOrnnM�ER1L�7MT PROPFNETORSAARTAWFUEXEMMVE 6HUB4N86974CU' 3�72 3262023 S'El -EA aFirnrff $ 1 LYe1,1W1AO m,.ad�FnON OF OPERATIONS Leedom E.L.O�ASE-POULYtaer $ 1,000p00.91 OFOPERATXONS/LOCAhENS/VE21JCLES(Attach ACORD'101,AddAoral ReLTAAln Sdhed,e,d mos space is te,t Ten• GENERAL_(.1ABILITY:fix legate and tsar: JOSS'aldte certificate holder is a,additives&iIDsellt Workers'Ccowe/Ts:4i=benefits ttdibe pad t,Massachusetts employees oak_Pursuant to Endoismienf 1NC20 03 06 8,no aoMntosbn is given to pay daPns for benefits to em0oyetes it states athert an Messadnmetts d the insured hies,Or has fired those employees outside of Massachusetts This certificate of insurance shows the policy in farce an the date thatmrs cerfificate was issued furless the e:c in/on date an the above policy precedes The issue date of this certificate of insurance)_The status of thin coverage can be monitored daily by accessing th.Pemfof Coverage-Coverage V rifs-sfidt Secede and at wervJtrasz - CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUQES BE CANCR 1 Fn BEFORE THE EXPIRATION DATE IT IS THE CUSTOMERS RE'ONSABILITY TO INFORME ANY SEXTON ROOFING&SIDING INC CHANGES OR CANCEL/.TlONS. 102 PINE ST.,HOLYOKE MA GUILHERME CAMOSSATD 1/1 01988-2010 ACDRD CORPORATION_AS rights reserved STATE OF CONNECTICUT DEPART-TIENT OF CO\SZ !ER PROTECTIO\ HO- IMPROVEMAIrr-CONTRACTOR of massachusetts cmornaingealtn _ flat Licansure civision of professi° d stantlamis an r specialri EVERETT J SEXTON SR Building 10 Pin*St ' COnStrUCt.Y.). "1 -10/05/2023 HOEYOXEi„MA 81.640-2411 cs-ti_4399689 SEXTON ROOFING&SIDiNG CO, • HIC.0605383 12Ici1f2o2x41 I 5 / 112023 pi-3 Bpi - • mAjpie,4 4 4rr • •4.1)ISSAEkk- SIGNED ' tranaut...- commissi°ner —0- Fie...giatTarttMereae RES PC.3?-1S ELF:: R.EG-4:STRATIZN ADDRESS E.:XPRAFION STAU:i3 DIVIDUAL NUMBER SEXTON ROOFING& SEXTON.EVERETT 113239 P_O_BOX 632T (.12(1,412023 Cunent Sang Inc HOLYOKE.IAA 01041 • • hupsalftenoicarramasasac. .• • • • • • • • •