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31A-031 BP 022-1538 27 FRANKLIN ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 31A-031-001 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-2022-1538 PERMISSION IS HEREBY GRANT, D TO: Project# INT RENO 2022 Contractor: License: Est. Cost: 55970 ALL-TEK BUILDERS INC CSL076435 Const.Class: Exp.Date: 11/18/2024 Use Group: Owner: BANKMAN JEFFREY A&TEDDI OL•ZEWSKI Lot Size (sq.ft.) Zoning: URB Applicant: ALL-TEK BUILDERS INC Applicant Address Phone: Insurance: 88G INDUSTRY AVE (413)736-0099 WC0452604 SPRINGFIELD, MA 01104 ISSUED ON: 12/05/2022 TO PERFORM THE FOLLOWING WORK: RENO KITCH,DINING &BATH 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 VI I ATION OF ANY OF ITS RULES AND REGULATIONS. Signature: AAk.. ).2 - 3-11 Fees Paid: $364.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner FThe Commonwealth of Massachustitts DEC / FOR W Board of Building Regulations and Standars• Massachusetts State Building Code, 780 Cl c-'0 IC PALITY / p,_„r UsE Building Permit Application To Construct,Repair,Ifenovat i* 4emp ,nv R ised Liar 2011 One- or Two-Family Dwelling r,4 0; jo,vs This Section For Official Use Only ! Building Permit Number: 6 i p3-3—/5'3Y7. Date Applied: Building45,14A..., 2 1111 j Official(Print Name) Signature / Date gn I. SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers Z5 f/z,/ N Y--1_/A/ e . 1.1a Is this an accepted street?yes 1., no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(It) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water S ply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public Private❑ Zone: _ Outside Flood Zone? Municipal 1pe6i site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: '-' _.7 y , vr. -r 1 NoZ- t ✓ /1A- 0/0 6 Name(Print) City,State,ZIP 2'X Fk."9Air— 4Al ; No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK'-(check all that apply) New Construction 0 Existing Building UV/Owner-Occupied 0 Repairs(s) p�Alteration(s) Addition 0 Demolition !p-/Accessory Bldg. ❑ • Number of Units Other 0 Specify: Brief Description of Proposed Work': K-17r— J7 DIN/N/i,, � 9-7 Ream( III/40.0E2 - •- . SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ ` , j� I. Building Permit Fee: $ Thdicate how fee is 4etennined: 1 0 Standard City/Town Application Fee 2.Electrical $ /2,/ 7, 0 Total Project Costa (Item 6)x multiplier x 3.Plumbing $/ 3 4f i. l), 2. Other Fees: $ / 4.Mechanical (HVAC) $ /'3 7 v d/ List: 5.Mechanical (Fire $ Suppression) T 11 Fees: $ #-�fi GI Check N o. 1710 Check Amount :At/ 6. Total Project Cost: $ q 7 D ull 0 Outstanding Balance Due: t 310q i J City of Northampton o'Y Massachusetts• �. ' DEPARTMENT OF BUILDING INSPECTIONS ?': 212 Main Street • Municipal Building Northampton, MA 01060 ssbi. PROCEDURE FOR OBTAINING A BUILDING PERMIT FOR WINDOWS, DOORS, ROOFS, RENOVATIONS, ROOF MOUNTED SOLAR, ETC. 1. Building Permit Application signed by legal owner and filled out by owner or authorized agent. 2. One set of plans and specifications of proposed work (Digital and hard copy). 3. Construction Debris Affidavit filled out and signed by applicant. 4. Worker's Compensation Insurance Affidavit filled out and signed by applicant. 5. Contractors must supply a copy CSL, HIC, and proof of Liability Insurance. 6. Energy Conservation Compliance Certificate (new /replacement windows). 7. Home owner's License Exemption Form (if applicable). 8. Note any Special Permit requirements (if applicable). 9. Energy Code —all new construction (Gut/Rehab) requires a HERS Rater Affidavit 10. Please provide the appropriate fee in the form of a check made payable to: The City of Northampton. 4 0 SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) 5--076 93s_ /4 / ERD 6 'g6Z . License Number Expiration Date Name of CSL Holder , T fr List CSL Type(see below) No.and Street / Type Description � ©/`D U Unrestricted(Buildings up to 35,000 Cu. tt.) R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 9/3/ 2,u' (96/S./¢44-74L'.BV/(/ ®61041 - I Insulation Telephone Email address ,COE-( D Demolition 5.2 Registered Home Improvement Contractor(HIC) 7536'.2.- A`Gt'T7' b."(-De-AA HIC Registration Number Expiration Date H CJany Name or Bic C Registrant Name No.and Streeth9u � 7' B�c-o� .© 1—f&� Email address a Cl5e' et� � 6-1/E aPMA7sad�� City/Town, State,Z /144-- O/J O if 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 0 No . ❑ 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 2i't— 7 v/e---0 en& to act on my behalf,in all matters relative to work authorized by this building permit application. / /! . 22/ 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 this application is true and accurate to the best of my knowledge and understanding. a-J/ ,e-Alo G '8EL_ M 2--Z.-- PrintOwner's or Authorized Agent's Name(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" * alds...... The Commonwealth of Massachusetts Department of Industrial Accidents r 1 Congress Street,Suite 100 Boston,MA 02114-2017 ....7.44k14/60v WWW.mass.gov/dia SVorkers' C'onipensation Insurance Affidavit:BuildersiContractori/Electrichins/Plumber-s. i ii tit. FILED WITH THE PtIMITTING AUTHORIT1. Applicant Information Please Print Legiblv Name(BusinessiOrganizatiosindividual): Address:_— . ,City/StatelZip: Phon ' Are yun an employer?Cheek the appropr rit: T" pc of project(required): i.C3 I am a employer with ample. . i ditir part-timet* 7. 0 New con.struction 20 I itri a sole proprietor or partnersh have no employees working for MC in 8. 0 Remodeling any i.4pacity.[No workers'comp.insuranu required.] 9.31:1 1 am a homeowner doing all work.myself[No workers"Cunap.insurance required.] 0 Demolition 1 0 Ei Building addition 4.0 I am a homeowner and will be hiring contractors to conduct all work on my property. I will enbure that all conir.sctors either have VOurken'corripensation ni.surant.r or are sole i i a Electrical repairs or additions proprietors with no emplo yi...i. .. 12.0 Plumbing repairs or additions 1C:I 1 ant a general contractor and I have hired the otb-contractor%listed on the attasited ilieet.. • There lalb..i:UatiM:k)M have enaployeet and have workers'romp 13.EI Roof repairs Insurance.: 14.00ther 6.0 We are a corporation and itt officers have exerci*ed their right of ckenrhini per NMI c. 1 52,.§1(4 and we have no employees.[No workers'comp.instuance:cquireill *Any applicant that checks IMA.1 m1b11 A64)till out the section beluv,Aill..,11..!,the a ..,or...._:1.Qimmt-matiun policy mfecmiavm *Hurneowricri who submit this atfistavit indicating they are doing all work and then lure otit.ido contracte.r%mint submit a new affidavit indimting such. .Contractors that check this box must attached an aidditioml sheet showing the name.,...f the suts-cuntractors and,tax v.nether or nut those erttalies have errapIkryers„ if the sub-contractuas have employees they most pro'.idc their worker.;,..orrip.N tic?.number I am an employer that is providing worArrs compensation insurance,for my.employees. Below is the policy and job site information_ Insurance Company Name: — Policy 4 or Self-ins.Lie.#: Expiration Date: Job Site Address: CityStatetZip: Attach a cop) of the workers' compensation policy declaration page(shorting the policy, number and expiration date). Failure to secure coverage as requited under MGL c. 152. §25A is a criminal violation punishable by a tine up to S1,500.00 andeor one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 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 certify under the pains and penalties of perjury that the Information provided above is true and correct.. _Signature: Date: Phone•7: Official use only. Do not write in this area,to be completer!by city or town official II City or Tows: Permit/License# Issuing Authority, (circle one): 1.Board of Health 2, Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector II 6.()tiler ' contact Person: Phone#: '... 41111111111111111111111111 City of Northampton rJvrj r . �. Massachusetts DEPARTMENT OF BUILDING INSPECTIONS WV 212 Main Street • Municipal Building Northampton, MA 01060 ,�" 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: 1 z3(74 c)761,40T) Location of Facility: `C4- & 2.EcyGG.Iuii A/ m4 01O6°J The debris will be transported by: 47 Name of Hauler: ��/� //4c." /42 Signature of Applicant: Date: /7 , • 2 - '\ r,, ,, ..:, City of Northampton „<„ Massachusetts �'� 'i� 7* i A), Is' p../ Pt �r DEPARTMENT OF BUILDING INSPECTIONS S$ f � i'+ 212 Main Street • Municipal Building cal ivy tiis - Northampton, MA 01060 'r'` .:,$. HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT I, (insert full legal name), born_ (insert month, day, year), hereby depose and state the following: 1. I am seeking a building permit pursuant to the homeowners'exemption to the permit requirements of the Massachusetts State Building Code, codified at 780 CMR 110.R5.1.3.1, in connection with a project or work on a parcel of land to which I hold legal title. 2. I am not engaged in, and the project or work for which I am seeking the aforementioned homeowners' exemption, does not involve the field erection of manufactured buildings constructed in accordance with 780 CMR 110.R3. 3. I qualify under the State Building Code's definition of"homeowner"as defined at 780 CMR 110.R5.1.2: Person(s) who owns 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 home owner. 4. I do not hold a valid Massachusetts construction supervision license and, except to the extent that I qualify for and will abide by the Massachusetts State Building Code's requirements for the supervision of the project or work on my parcel, I am not engaged in construction supervision in connection with any project or work involving construction, reconstruction, alteration, repair, removal or demolition involving any activity regulated by any provision of the Massachusetts State Building Code. 5. If I engage any other person or persons for hire in connection with the aforementioned project or work on my parcel, I acknowledge that I am required to and will act as the supervisor for said project or work. Signed under the pains and penalties of perjury on this day of , 20_. (Signature) y -/ ;:,,.. /• ; , .=� 9 of .�_ _. .'1. - ' (BASEMENT FOR#27) O View from Street 3 Scale:Not to Scale O Locus Map UP-�—► I pier c 2 Scale:Not to Scale I I I I I her I opening in wall �-�- CRAWLSPACE It) I to crawlspace _ — UNDER#27 / La' E under adjacent unit / CHIMNEY 1 ace BASEMENT m I LAUNDRY dryer UNMEASURED I h ' BASEMENT I 12.-6" 11'-3" AREAApproximate -\((8"x8"timber post Exterior Line on 8"x12"brick I of Porch base i 'TC-I I N UPS it; electric \ n ii eBasement Plan C Scale: 1/4"=1'-0" APPROX Bankman Renovation DRAWN BY: y• NUMBER DATE 25 Franklin Street JHale Drafting Services Unfinished Existing Basement Plan, Oct 20, 2022 A--1.0 Northampton, MA 413371-2306 Locus Plan and View from Street JenNlerNaleQoutlookcom C drawers drawers corner Build out and finish wall ADJACENT UNIT: Build out wall to accommodate corner wiring around basement stair well #27 FRANKLIN STREET 3'-0" 3'-0" 2'-2"/ New base and upper cabinets (cut 11 IIIIIII / i i 'i , -out corner of cabinet box as needed UP I x DN REF -� L,-j� to accommodate wiring In corner) I .� Ir c �I i :r 8 New range location,redirect stove vent FRONT 8 HALL LA�L - Niche or i° rAgit 5.-6 �\` C,O $, New kitchen island and Sink/DW/trash ill I shellvin 2'-0" 2'$" '-0",-3,-0" O • .ull-out,with counter/bar on Entry side g'�- - / '—`,_ Remove existing / _ sound r T —;c ` I L loan of ADJACENT window,add new insulation — I( I 4 1 k UNIT:6#27 FRANKLIN cy�� G behind '? v - 3 g I _�_'I $ _ taller window(to LIVING �(. v STREET) I match existing *r' .� Mad �' I)<I c \'" windows @ south wall)under header ///////7f \ fv ` � vx- r � 6'�{" R 5"New wall to surround movedWrap plumbing vent(and heating - "Bar Counter acabinet,house duct toducts as necy)with finish wood Existing basement second floor bedroom Kcovering to match posts44"Half wall withMIMI hatch to remain in ssibiewood cap finishplace until Future Wrap post with finish wood i i\IPhase Existing Heating Grate to remaincovering / i Existing porch and ENTRY "�� back entrance to .a DINING ROOM / \ _� remain in place New location for existing cabinet 44"Half wall with wood cap finish,- ' avoids Heat Supply Grate in floor gyp @ Dining Room,Sheet bead _ '4 until Future Phase board @ Entry side T CLOSE , Vi I Path and Steps to Existing overhang Area of New remain in place above,(§second +/- 23'-1 1/2" Flooring:215 SF until Future Phase vc floor EXISTING Approx location of Existing Heating Grate to remain Area Calculations New Beam to First Floor Interior Floor Area:886 SF support floor O First Floor Plan above,TBD by First Floor Area of Renovation:276 SF y Scale:1/4"=1'-0" Beam Mfr •IkP OCL-s- 0 EXISTING EDGE O APPROX Bankman Renovation DRAWN BY: ti NUMBER DATE 25 Franklin Street JHaleDraltlngServices First Floor Plan rn Oct 20,2022 A—I.1 Northampton, MA Jenn*aoutlookopm o: ADJACENT UNIT —New Wall between closet New 48"Vanity and bathroom,drywall, with one sink Demo Stair to First Floor, finish to match existing Approximate Existing Fill In Floor,install(5-6) 4'-8" 3'-0" Chimney outside ADJACENT UNIT:#27 FRANKLIN STREET adjustable wire shelves exterior wall /N, New Low-flush l Energy StarToilet in / I I BALL i I I , ,iI I, I r i r existing toilet location > . . , Y, New Floor,Fill in Door and opening pl BATHROOM Floor at Stair location, - to remain,change to match level of swing direction to existing floor,Demo existing floor material, '-- TOR •"• new flooring over all. --- �� L= l Demo sink,wall,tub _1= I IIII _A. and install new 60"x30" _ o F.. walk-in shower unit New 36"x36" � - g° walk-in shower BEDROO M I possible new 41J2" 2'-6" -01/2" locations of heating In a. 6 1 a d ninge Washer r grate in floor ry New Low-flush Existing closet - N Energy StarToilet 4 1/2" to remain 'C'r + New 30"Vanity __ BEDROOM Z with sink ..----------Area of New Flooring P r ' \ material(TBD)in Line of Exterior Wall below 7-8" Laundry and New Area Calculations r I r I Bath:120 SF "'-8 existing Second Floor Interior Floor Area:786 SF +/-10 g Wall to be postloned/ and built to maintain Second Floor Area of Renovation:204 SF O Second Floor window trim around Scale:1/4"=1'-0" window N APPROX Bankman Renovation DRAWN BY: fri NUMBER DATE 25 Franklin Street JHakOraltlno Services Second Floor Plan Oct 20,2022 A-1.ZA Northampton, MA "�oom ADJACENT UNIT 027 Wall and door in V corridor to remain I I i _ i Pulei p—► I • DN DNI I I li covI ' ` I 1 A *-No work _ ' ' , \,. dt+u . In Hall , ' 1S V$0 D i Closet _ Remove wall and Ulna= door to Bedroom 3 =�___ V __��� "'r bathroom Remove door and trim, lZ save for re-use In bedroom 2 s / BEDROOM 3 =NMI / Demo wall to install door from Bedroom 1 r A. P 9 P 1 F i P ii• Second Floor Existing Conditions and Demo Plan Scale:1/4"=1'-0" G APPROX Bankman Renovation DRAWN BY: io NUMBER DATEZ 25 Franklin Street JHab Drafting Services Existing 2nd Floor and Demo Plan a Oct20, 2022 Ex-1.2 413-522-2306 J Northampton, MA .nnreennPortiabttloNbokcom -emove stair to second floor ADJACENT UNIT: and wall below _ #27 FRANKLIN STREET U I j . DN T/ —I l —_ , / 'emove kitchen cabinetry UP 1 ��---- I Ll I and appliances rn� i Z` — FRONT = II II 1 -emove wall between Kitchen U----k L J HALL jg\( I I and Dining Room,support floor I L.----J above with new beam,TBD I / o m .—1I joart of ADJACENT LIVING c4�- I —�I , ► I STREET)UNIT: #27 FRANKLIN 1200M Dw Remove built-in L---- historic cabinet for re-use(see A-1.1) r li I MUDROOM/PORCh( r1 IL I PINING ROOM i:NIBY T . , p----9 r -��� ,1 i q 1 ,IL Remove flooring in kitchen First Floor Plan Existing Conditions and Demo Plan Scale:1/4"= 1'-0" APPROX Bankman Renovation DRAWN BY: -- 6 NUMBER DATE 25 Franklin Street JHele Malting Services Existing 1st Floor and Demo Plan °- Oct 20, 2022 Ex-1.1 413-522-2306 Northampton, MA JennHerHab@outlodc.00m K 11/29/2022 12:51 4137318255 BATESFULLAM WEST SPF PAGE 01/01 AC R'C.0' CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYrr) ki..----"' 1 1/29/2a22 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; lithe certIflcate holder is an ADDITIONAL INSURED,the pollcy(iea)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 Gloria Linzi NAME: BateE Fuliam Insurance Agency,Inc PHONE( (413)737-3539 —�AX 413 7 975 Elm Street uuc IL No,Ern. (PJC,No): ( ) 31-8255 ADDRESS: glinzi@batesfullam.com INSURERS)AFFORDING COVERAGE NAIC a West Springfield • MA 01069 INSURER A: Main Street America Assurance Co. 29939 INSURED .�... INSURERS; NGM Insurance Company 14788 All-Tek Builders,Inc INSURER C: Star Insurance Company 18023 sa INDUSTRY AVE STE G INSURER D: INSURER E SPRINGFIELD MA 01104-3263 INSURER F: COVERAGES CERTIFICATE NUMBER: 22-23 gl,wc,auto 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 I 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 "' ADM_IN,Ial"' - - EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER Y err PMI DIYYY (MNIfDD/YYYY) (MM/ODlYYYY) LIMITS, COMMERCIAL GENERAL LIA61LITY _ EACH OCCURRENCE . ,000,000 DAMAGE it kEN I'ED 500,000 CLAIMS-MADE OCCUR PREMISES(Ea occurronoc) $ MED EXP(Arlwone person) $ 10,000 A MPM19810 09/07/2022 09/07/2023 PERSONAL&ADVINJURY $ 2,000.000 GENII_AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 X POLICY PRO- PRODUCTS-COMP/OP AGG„ $ JECT LOC 4,000,000 OTHER $ AUTOMOBILE LIABILlrr COMBINED SINGLE ElM i' -^^— (Ea accident) 8 1,000,01)O ANY AUTO 7 BODILY INJURY(POT oer5On) $ B — OWNED 'SCHEDULED M 1 M 19810 08/04/2022 08/04/2023 BODILY INJURY(Per accident) 6 AUTOS ONLY X AUTOS HIRED v NCN-OwtNLY PROPERTY DAMAGE X AUTOS ONLY X AUTOS ONLY leer accidarn i' UMBRELLA LIAR OCCUR CACI I OCCURRENCE J— $ EXCESS LIAR CLAIMS-MADE AGGREGATE 1 DED 1 RETENTION S Ty $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y/N X STATUTE X TRH_ ANY PROPRIETOR/PARTNER/EXECUTIVE r Y NIA WC0452604 500,000 C OFFlCERlMEMBER LXCLUDED7 I 09/2o/20Z2 09/20/2022 ,.E,L.EACHACCiDENT (Mandatory art NH) 500,000 IT ved.tledcWe underE.L,DISEASE-EA EMPLOYEE DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 90'S,Additional Remarks 8Cneaule,may be attached if more space le required) v Commercial and Residential Remodeling and Additions. Wayne Albrecht and W Iliam Gabal are excluded from Workers'Compensation coverage. RE:2$Franklin St.,Northampton,Ma CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town of Northampton ACCORDANCE WITH THE POLICY PROVISIONS. 212 Main St. _ AUTHORIZED REPRESENTATIVE Northampton MA 01060 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD