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23A-237 (3) BP-2024-0218 171 NONOTUCK ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 23A-237-001 • 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-2024-0218 PERMISSION IS HEREBY GRANTED TO: Project# SIDING/ROOF 2024 Contractor: License: WILDE HSE LLC DBA SEXTON Est. Cost: 40010 ROOFING 106265 Const.Class: Exp.Date: 03/08/2027 Use Group: Owner: HAGELSTEIN, ERIC& SUSAN L. Lot Size (sq.ft.) Zoning: URB Applicant: WILDE HSE LLC DBA SEXTON ROOFING Applicant Address Phone: Insurance: 45 OLANDER DR 315-569-7761 6H1JB0W551 13923 NORTHAMPTON, MA 01060 ISSUED ON: 03/01/2024 TO PERFORM THE FOLLOWING WORK: SIDING AND STRIP AND REROOF FRONT PORCH 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: ,t444 44..4 Fees Paid: $100.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner f / FFB The Commonwealth of Massachuseths..� ` ? FOR Board of Building Regulations and Stand rdse�... MUNICIPALITY % Massachusetts State Building Code, 780 CitRR.,,,r� ins. USE Building Permit Application To Construct,Repair,Renovate Or tYtlish a Revised Mar 2011 One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: 80- Z N- 21 'p Date Applied: Loat.5 R3SrotMJC— Building Official(Print Name) ! Signature to SECTION 1:SITE INFORMATION 1.1 Property Address: 11 0 to5-i ck ST, 1.2 Assessors Map& Parcel Numbers `(Wi O1O(.DO 1.1 a Ts this an accepted street?yes f no Map Number 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) 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: Zone: Outside Flood Zone? Public Ur. Private❑ Check if yesCa' Municipal l3 On site disposal system 0 SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: J \ %W\ kI1_L E 1 f \ O 1 0 t O Name(Print) City,State,ZIP L 1 l K\ 1•1(C Ike& s—. (y,�433-301/ G P Qvw-N L.(pm No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building lti{ Owner-Occupied Repairs(s) l Alteration(s) 0 Addition ❑ Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work2: �M„J E Xs S1 �1Ca-51_'bl�C-v 1ov� To S 't ii114Ct k's g-t l,L 4:it/fir csfapq� -,t� 9_,��1az kot,.�ss S4Ng (+��. (nts►Au. n�F.v3 V t .� L S t O► C-� 43-ri�svL N s-«a tA_ �rz W. .k .o �� 'fi W t&\•11awS (L.�1L�,s, f, F�asL, e.s i l..�sTrat� V��yl. ,ST)Ccr 17. ? -tbJ1: (as-r 1MZAA1 Codee SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 3y 3$O,00 1. Building Permit Fee: $ Indicate how fee is determined: ❑ Standard City/Town Application Fee 2.Electrical $ ❑Total Project Costa(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire Suppression) Total All Fees: $ Check No. )QZ iCheck AmootjV Cash Amount: 6.Total Project Cost: z�O ❑Paid in Full 0 Outstanding Balance Due: The Commonwealth of Massachusetts 14. Board of Building Regulations and Standards FOR Massachusetts State Building Code,780 CMR MUNICIPALITY ' USE Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: Date Applied: Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: I `� )0 t0011.AGL Tr- 1.2 Assessors Map&Parcel Numbers M0RZV , rit • 010(o0 1.1 a Is this an accepted street?yes no Map Number 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) 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❑ Zone: _ Outside Flood Zone? Municipal❑ On site disposal system ❑ Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Name(Print) City,State,ZIP No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building liih Owner-Occupied fRepairs(s) PJl Alteration(s) Cl Addition ❑ Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work2: (f rneV 2 x.ts-r l r\a► Th ET A L (Ni Ite tJ► Po kr,M -€ck ry>ti Icy w+�i ram, Ian-� iA t111 SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 30 at) 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ 0 Standard City/Town Application Fee 0 Total Project Cost'(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Suppression) Total All Fees: $ Check No. Check Amount: Cash Amount: 6.Total Project Cost: $( 5 ' 3a 00 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) \S I V AR1 L l I b�, License umber Expiration Dat Name of CSL Holder v� LAD c S gc_.`cList CSL Type(see below) LJLJ D L-f• b FAL No.and Street Type Description �\ O l O O U Unrestricted(Buildings up to 35,000 Cu.ft.) 1 U lc-\�'fiYv‘irc, I R Restricted l&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding / SF Solid Fuel Burning Appliances t 1r 13)5311—/jL S1:J vrt.1RooF I4etDFF1Gf,C I Insulation Telephone Email address (.tmAl 1 aW D Demolition 5.2 Registered H me Improvement Contractor(HIC Qp g 970 � MC Registration Number Expiration Date HIC Corn any Name or HIC Registry Name 95 U/ ..liN6 • 5t.'x-colJg.on I+�I C�10EC 1 CA No.and Street C 1i7N 01WOO ( tii)534-193q Email address NCR��ta 1 C1 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 No 0 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1 I,as Owner of the subject property,hereby authorize 7X V O ,p J ,piY ttJ fg. Cat to act on my behalf,in all matters relative to work authorized by this building permit application. 02.423/02V Print Owner's Name(Electronic Signature) ate 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 conta. :a in this application is true and accurate to the best of my knowledge and understanding. Nias/44,,Z(1./lez , // Pri wner'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" City of Northampton 1 ptMP S.S,...-'.~..,SQL, !�••" Massachusetts �<4, k- 'ee y I,� i• .. is DEPARTMENT OF BUILDING INSPECTIONS �' - '111 212 Main Street • Municipal Building yeti cam Northampton, MA 01060 s.5'1,h, .1,-,''"�� 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: Ti Uk Yv ,� 5 i Location of Facility: S A Ste. _ Olt The debris will be transported by: Name of Hauler: 1\5 5Oci (ai 7 �1A,I'h M1 n LAIKE KE..,(( Signature of Applicant: l�1Z Date: The Commonwealth of Massachusetts - _ - ; Department of Industrial Accidents - vt 1 Congress Street,Suite 100 • { Boston,MA 02114-2017w r :;kurww mass.gov/dia { )%uikers'Compensation Insurance Affidavit:Builders/ContraetorslEkhriciaus/Plumbers. TO BE FILED WITH THE.PERMUTING AUTHORITY. Applicant Information Please PrintI..rth �ib Name 1Hustness(1rleaniratwn Individual):SE`�vN o . �.�tJ e' ikt S 1 of`_V l'L Address: ,5 01..,iP \V l> Z 72--. ( s3t-1_1&3 CityfStatc1Zip: pQ, ' i\ 1 I O) hone#: %re,ton an rmpluyrr'( brie the appropriate,hot: Type of project(required): 1.3 I am a employe(with employe'..hull and or part-tinaci.• 7. 0 Ness construction 20 I sot a mile proprietor not partnership and has.no employee%*working for no:m X. CI Remodeling any capacity.[No war►en'crimp.msuraner required" 9. ❑ Demolition s0 I atn a n eso eucr doing all Nark myself.No*osiers'comp.insurance required"' 10 O Building addition i.O I am a honau'iier and will be hiring contractor.to camdud all Murk on my property. I will down that all contractors either have swam'cam�a.nsatum inrinaaax or arc mile I I a Electrical repairs or additions pn4,nctor.Muth no etnpluyeel. 12.0 Plumbing repairs or addition_. S am a general contractor and I hay a hared the mda.contractors Bind ea the attached sheet. these mi!•-a:amtracton Ieas. m cpk,yt<•es and Ica)e w.rk. comp.'comp.ianaatae.^ !I Root repairs h.D w,an ep a courauun and its otlwm hio a immersed then right of eM b c un per\Ail . 14.2010 ` l 152.t 114).and we hale no enipkeyeocs.(No Markers'comp.inatrance reyuurrl) •My applicant that.hacks bona 1 must also fill out die seetiam bettor tienr.ing their workers'compensation policy:formation. Iirrr►.wMncn Mau anoint thus aflida.at indicating dies arc doing all work and tarn hue outside contra..tors rate,Mlhtrit a new attula'it indicating such. :(untraeton that check this bare mum:attached an aaldiUonal sheet%bow rug the name col the with-.oriuLi,.K,and OM ndiL1hcr of riot therm entities haae cmpk,yec, II the,uh.ontraet.x,lu.e cn;rloy..,,the!, tau,l pta,.adc th.0 worker.'.vane po t..tnaarnl,,r. 1 am an employer that is providing workers'compensation insurance for rnl•employees. Below is the polity and fob site information. Insurance Company Nate — Polies ::or Self ins. Lie. :: Expiration Date: 1 Job Site Address: Lu I IQO{�)(�UG 1 , � , CityStateLip: )Oc biV) 61 Attach a copy oftworkers compensation policy declaration page(showing the policy number and expiration date). 0)0(pc Failure to secure coverage as required under M(iL c. 152.§25A is a criminal violation punishable by a tine up to S1.500.00 and or one-year imprisonment.as well as cisil penalties in the form of a STOP WORK ORDER and a tine 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 s eritication. 1 do hereby certify under the pain and penalties of perjury that the information provided bore 's true and correct. Si•nature ����La�l,C�/ Date b //" Ptionc= t ` /1 iz 9—10a ellidol uya't►nli. Do not write in this area.to be completed be,city or town official. ( its or I own: Permitilicensr sy Issuing.authority (circle one): I. Board of Health 2. Building Department 3.('ity Town(lerla 4.Electrical Inspector 5. Plumbing Inspector 6.Other -- ( outset Person: Phone 0: 2/23/24,3:45 PM LP Baruch WC Affidavit.jpg The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 www.mass.gov/din 1%nrkers'Compensation Insurance Affidavit;fluilders/Contractors/Ekctridafs/Piumben. TO RE FILED WITH THE PERMITTING AUTHORITY. Analicant Information Please Print Ltgibly Name 1Nuaincan.'Organization'lndnvidual}: f�� � (j `��C• Address: ka3i_ fZc,�hbnat. t k4.0a city/state/zip:u1�t '� o�� _ Phone#: Are yea a ernpkay rr..Check air appropriate box: Type of project(required): La 1 am a employ cr w u u L -employecs(full aryl or putt- ael-' 7. 0 New construction 1 am a wile proprietor III partnership and have no employees w'urkine for me in Il. ©Remodeling capamis..[No wort.cn coup.insurance squired.) 9. ❑Demolition 301 am a horna,wner doing all wank myself.[No workers can{,_imucrnx nquind.]' i U[)Building addition 4.0 1 am a homouw net and will be hiring cuntrrcrun to cuathiet all wink un my property.. I will ensure that all contractors either have workers'compensation insomnia:or ate sole 11.❑Electrical repairs or additions prupriders w ill:no employee. 12.0 Plumbing repairs or additions 501 am a e1wa1 contractor and I have hired the sub contractors listed un the attached sheet. 13 a lewo f repairs These sub-contractors have employees and have workers'comp.insurance.: "" tea # [,� CO • er a D► OWe area Carp oeatiult and its officers have exercised that right of exemption per hfGL c. 13'_5101.and we have nu employees.[No workers'comp_insurance required.] *Any applicant that checks boa al moat also fill out the section below showing theirwurles'compensation policy information. IL nenwuro who submit this athrkavit Militating they are doing all work and then hire outside contractors must submit a new affidavit rudaylmg sin*. !Contractor,that cheek this fox must attached an additiunal shed showing the,name of the sub—contractors and state whether Of not those entities have employees It the sub-contractors have employees.they must provide their wuriters'coop.policy number_ I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and Jab site information. Insurance Company Name: Al Arneci its "±fYstMti.vscg• (-es — Policy or Self-ins.Lie.#: (QS \t iCtto`i46Q3 Expiration Date: UV 11 .w2y / Job Site Address: /`C 10 N OU,C City/state/Zip: D � b�l`� Qj Attach a copy of the workers'compensation policy declaration page(showing the policy number and espiritioa date►. Failure to secure coverage as required under MGL c.152,§25A is a criminal violation punishable by a fine up to S1,500.00 and/or one-year imprisonment.as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to 5250_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 ofperjtay that the information provided above is true and correct. Signature: ;(�y37.( 1��3/'1 Date: C I/ �%mil 7OZ Phone x: —` Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License tF Issuing Authority(circle one): I.Board of Health 2.Buikling Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone https://drive.google.com/drive/folders/1 EJlauznxk442ABFg7A82m8pToYeiOXwe 1/1 A�ORO® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDrmrY) 09/12/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must 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 Kathi Hutchinson NAME: FAX ORMSBY INSURANCE AGENCY A"�" etc: (413)737-0300 Noe AooREss, khutchi!nson@omtsbyins.com P 0 BOX 718 INSURERS)AFFORDING COVERAGE NAIL WEST SPRINGFIELD MA 01090 BISUpERA: TRAVELERS INDEMNITY CO OF AMERICA 25666 INSURED INSURER B: WILDE HSE LLC INSURERC: INSURER D: 45 OLANDER DRIVE INSURER E: NORTHAMPTON MA 01060 INSURER F: COVERAGES CERTIFICATE NUMBER: 929774 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. BPOLICY EFF POLICY OW URR ADM TYPE OF INSURANCE gD SWUVBR POLRCY NUMBER UBWpD/YYYY) (MMIDDIYYYYI LIMITS COMMERCIAL GENERAL LIABLI Y EACH OCCURRENCEDAMAGE TO RENTED S CLAIMS-MADE I OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY jEE-CT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY ( BINEDEa aDtSINGLEUMI' $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS N/A BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTYdDAMAOE AUTOS ONLY AUTOS ONLY UMBRELLA LIAR OCCUR EACH OCCURRENCE S EXCESS UAB , CLAIMS-MADE N/A AGGREGATE $ DED RETENTIONS 3 WORKERS COMPENSATION TH- X S STATUTE R ER AND EMPLOYERS'LIABILITY A OFFICER/MEMBERFEXCLUD D?ECUTNE N/A N/A WA 6HUBOW55113923 06/01/2023 06/01/2024 E.L EACH AccwENT $ 1,000,000 (Mandatory In NH) E.L DISEASE-EA EMPLOYEE $ 1.000.000 If yes,describe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY UMif $ 1,000,000 N/A DESCRIPTION OF OPERATIONS!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/. Continuation of above Named Insured:DBA SEXTON ROOFING&SIDING CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Northampton 210 Main Street AUTHORIZED REPRESENTATIVE Northampton MA 01060 Daniel M.Crowley,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD WILDE-1 OP ID: KH ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) �-� 09/12/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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 CONTACT NAME: Ormsby Insurance Agency,Inc. PHONE FAX 698 Westfield St PO Box 718 (A/C,No,Ext):413-737-0300 I(A/C Noy 413-737-0617 West Springfield,MA 01090 E-MAIL Eric Dembinske ADDR E SS: INSURER(8)AFFORDING COVERAGE NAIC# INSURER A:Northfield Insurance Company INSURED INSURER B.The Travelers of MA 10647 Wlde HSE LL dba Commerce Insurance Co. 34754 Sexton Roofing&Siding ,INSURER c 48 Olander Drive Northampton,MA 01060 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 ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD INVD IMM/DD/YYYY1 /MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY 1,000,000 EACH OCCURRENCE $ _ CLAIMS-MADE X)OCCUR WS556514 05/30/2023 05/30/2024 DAMAGE ES TO(Ea RENTEDoccurrence) ; 100,000 PREMIS MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO- I 2,000,000 X POLICY JECT LOC PRODUCTS-COMP/OPAGG ; OTHER $ C AUTOMOBILE LIABILITYCOMBINE(Ea SINGLE LIMIT $ 1,000,000 nt) ANY AUTO L11219 06/30/2023 06/30/2024 BODILY INJURY(Per person) $ AURTOS ONLY X SCHEDULED BODILY INJURY(Per accident) $ X HIRED ONLY X NON-OWNED ON-O ONLDD PaOPERTY DAMAGE $ r accdent $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N ISSUED SEPARATELY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) I E.L.DISEASE-EA EMPLOYEE $ II yes,describe under DESCRIPTION OF OPERATIONS below ' E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) 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 DELIVERED IN City of Northampton ACCORDANCE WITH THE POLICY PROVISIONS. 210 Main Street Northampton, MA 01060 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD C� DATE(MMIDDfYYYY) A CERTIFICATE OF LIABILITY INSURANCE 08/15/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must 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 BRUNO ROZEMBARQUE NAME: POINT INSURANCE INC H No Exd: (617)783-1160 •jAJC,No): ADDRESS: bruno@pointinsure.com 1103 COMMONWEALTH AVE INSURER(S)AFFORDING COVERAGE NAIC# BOSTON MA 02215 INSURERA: ACE AMERICAN INSURANCE CO 22667 INSURED INSURER B: L P BARUCH INC INSURERC: INSURER D: 637 RATHBUN ST APT 2 INSURER E: BLACKSTONE MA 01504 INSURER F: COVERAGES CERTIFICATE NUMBER: 921636 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. LTR TYPE OF INSURANCE INSD SUBRW POLICY NUMBER (MMIDDIYYYY) (MMIDD/YYYYI LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCECiAMAa TO $ _ CLAIMS-MADE OCCUR PREMISES(Ea RENTED occurrence) $ MED EXP(My one person) S N/A PERSONAL 8 ADV INJURY $ GEWL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S POLICY ,IEEC LOC PRODUCTS-COMP/OP AGG S OTHER: S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) S OWNED SCHEDULED N/A BODILY INJURY(Per accident) S AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) S 1 , UMBRELLA UAB OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE N/A AGGREGATE S DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE EL.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A N/A N/A 6S62UB0W59692023 07/11/2023 07/11/2024 1,000,000 _ A (Mandatory in NH) EL DISEASE-EA EMPLOYEE S If yes,describe under DESCRIPTION OF OPERATIONS below EL.DISEASE-POLICY LIMIT $ 1,000,000 N/A DESCRIPTION OF OPERATIONS/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 ACCORDANCE WITH THE POLICY PROVISIONS. Sexton Roofing&Siding 102 PINE STREET AUTHORIZED REPRESENTATIVE HOLYOKE MA 01040 Daniel M.Crowley,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Licensee Details Demographic Information ull Name: SASHA MARIE WILDE wner Name: License Address Information City: NORTHAMPTON State: MA Zipcode: 01060 Country: United States License Information License No: CSSL-106265 License Type: Construction Supervisor Specialty Profession: Building Licenses Date of Last Renewal: Issue Date: 7/6/2023 Expiration Date: 3/8/2027 License Status: Active Today's Date: 7/7/2023 Secondary License Type: Doing Business As: Status Change Reason: License Issuance Prerequisite Information No Prerequisite Information No Available Documents THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington Street-Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration ; Type LLC �.{ tyy I Registration 206470 �'•"wDE KSE ilC } c tr. Exp+ration 04 3QO25 D SA SEXTON ROOFING I MOOG t , 4$OtANDER OR w • NORTMAMPToti MA 03104 { 1�. Ufldsle Address and Return Cats. Ttl!COSPICsrArtALTw OF MASSACHuSETTI Ofllss N Consume.A*sw S ausinsss Itepulaoen Rselseratlon raid lot and Mduol imp only adore fate ►fOitE IM►ROYEMENT CO,TRACTOR sapkwen die. feast flews to: TYPE . ; 011los N Canes o►Affairs sod Soars.RsulNYan ION Wrest •Suds 710 e' frfarroo sea Soften.NA 11$ MADE MSE,tic O$A SEXTON ROCOMiG a SO NO SASHA wt.DE 45 OLAMOIR DR NORTMAMOToN.fMA 03104 un'sssaslary Not valid without signature 2/23/24,2:42 PM 171 Nonotuck St Siding Signed Contract.jpg "'• WILDE HSE, LLC wool SEXTON ROOFING AND SIDING Vift0 www.sextonroofing.com Setting the Standard p.413.534.1234 45 Olander Dr. info@sextonroofing.com Northampton,MA 01060 MA HIC II 208470 SUBMITTED TO I '?` PHONE L. "'6 ,'_ DATE - 7 �= i C� fit;�}� �� c_w� // ? �' 'j C Jl ��f- %% 2.Y STREET I -� 1;,:y'C• ' •t_ 1.- _ .i— EMAIL CITY,STATE,ZIP I FL "'.rc.y C'.C j4 t�� Vinyl Siding I Areas to be Sided: Product: Profile: Corners: Color: i.,Front Prodigy iii.."-tlapboard Siding: tandard � e C' r L/Left Odyssey Dutchlap ,/ E L‘ri^-(1. Back y,'.. -Charter Oak C Other Outside Cot rs: Y Right -Pelican Bay Shakes E Roughsawn Designer' • Mastic Z,Aiand Split • } ' 'White Only Insultation: Rounds / 3/8" li' or Tyvek✓" Soffit,Frieze Board&Gutters Areas to be covered: New Gutters&Down Spouts3 Front Left Back Right Color Other Area Soffit&Fascia i� fe Cr -' "U i?,'f' tom' Frieze Board' O 7, 71 C Color _ No Soffit Only 0 D C 0 3 New gutters&down spouts to be Fascia Only _ _ O C Tuck Fascia _ 0 n installed in existing locations, unless noted below, Cover Frieze board with: PVC Alum.Coll _ or Vert.Soffit 68 id"- Remove Existing Siding' Yes I>E No _ If Yes, Vinyl/Wood 4--- Aluminum `Only where new siding is to be installed.Sexton Roofing&Siding will NOT remove asbestos material. Porch Ceiling,Beams&Posts Accessories Lights Blocks iZ"i Double 5"Remmer Color: eV`f Elf"-" Standard 0 Lai!(, el'44 ' Charter Oak Beaded Soffit / Custom C 13 (r V 6' Vented Soffit �� Location: 4-[,, Split Blocks 4+"-" Other . Stone Work 7- t =._. Gable Vents - I -c'..i €,.C./. t'( C `_t ' `.` ' r 01,1 j Shutters ,<' %,`i . Replace Rotted Wood Specify the locations: Special Considerations I t I have reviewed and agree with the job specifications described above. If rotted wood is discovered AFTER removing the existing siding,or if it could not be identified at the time of sale there will be an additional charge of $ per Sq.Ft.for Plywood and S_ per Lin.Ft.for Dimensional Lumber. Customer Signature: Date: We propose hereby to furnish� material and labor-complete In accordance with the above specifications,for the sum of Total Sales Price$r (7er 4�8 g- i/3 Down Payment$ \t , VC) Balance due upon completion$ Arr'ptance of Proposal:The above prices,specifications and conditions are satisfactory and are hereby accepted.You are authorized to do the work • as specified.Payment will be made as outlined above.Unpaid balances shall accrue interest at 18%per annum.Purchaser(s)will pay for all costs, expenses and reasonable attorney's fees I rre\1 by Wilde HSE,LLC DBA Sexton Roofing&Siding to recover any sums due under this contract. Customer Signature: !_�"/ �` - 1 C- `Date: t� Authorized Signature: /� } Date' o2` / x 1 �L�l� te:This proposal is honored for(30)days from above date. PLEASE REMOVE ALL BREAKABLES FROM INTERIOR WALL SURFACES DURING INSTALLATION.Sexton Roofing&Siding will not be responsible for damage. 4 A 1.1 Ftesized 5334790961491590295.}peg 2/23/24,12:56 PM W W W.s extonro o fing.c on p.413.534.1234 4 ' info@sextonroofing.corn rr 45 Colander Dr. Setting the Standard MA HIC#208470 Northampton. MA 01060 SUBMITTED TO Eric laa:elstein PHONE 413-433-3091 DATE 1/22/2024 STREET 171 Nortotuck St EMAIL ephagei�a^gmail.com CITY,STATE,ZIP Northam.ton,MA 01060 roofr SEXTON ROOFING HEREBY SUBMITS SPECIFTCATioNs AND ESTIMATES FOR:Front porch,metal 1) Strip and remove existing metal and dispose of in proper landfill. 2) inspect roofing deck and replace as needed @$100 per sheet. 3) Install ice and water shield on entire porch. 4) Install metal roofing system as per manufacturer's specifications(similar to Everlast Omni Series) 5) Supply manufactures warranty and SR&S 5 yr.workmanship warranty. ATTENTION HOMEOWNERS:Please cover all personal belongings in the attic,garage,or storage areas due to possible roofing debris or dust coming through cracks of wood decking. Sexton Roofing shall apply for all permits. We propose hereby to furnish material and labor-complete in accordance with the above specifications,for the sum of Five thousand six hundred thirty dollars($5,630) Payment due in full upon completion All Material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any n /? alteration or deviation front above specifications involving extra costs Authorized j,. /LEA �� will be executed only upon written orders,and will become an extra Signature /� / 'V charge over and above the estimate.DAMAGES TO BUSHES AND OTHER VEGETATION'MARKS ON HOUSE MAY BE UNAVOIDABLE Note:This ma proposal beithdus if not accepted within AND WE ARE HELD HARMLESS. Not responsible for water damage withdrawn by during construction. Owner to pay responsible legal fees for (5)days. non-payment,and applicable interest. Acceptance of Proposal The above prices,specifications and conditions are satisfactory and are hereby accepted. You Signature i a are authorized to do the work as specified. Payment will be I made as outlined above. Date htinc•)lr.,�il rvnn..l.. ...,.:I .ln in._t---�.o_-�u-'—-,_,•-..... .—.. ...