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23A-079 (29) BP-2024-0703 41 MAIN ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 23A-079-001 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-2024-0703 PERMISSION IS HEREBY GRANTED TO: Project# INTERIOR RENO 2024 Contractor: License: Est. Cost: 3000 RAMZI NATOUR 113691 Const.Class: Exp.Date:01/13/2025 Use Group: Owner: FALK 41 MAIN LLC Lot Size (sq.ft.) Zoning: GB Applicant: RNR REMODELING Applicant Address Phone: Insurance: 19 EDWARD CIRCLE (413)313-1201 NXTAZOTRNO-04-GL LONGMEADOW, MA 01106 ISSUED ON: 06/12/2024 TO PERFORM THE FOLLOWING WORK: INTERIOR RENO 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: 1/7" Fees Paid: $100.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner RECE!V -A' 2=rva 1N 20'The Co monwealth of Massachusetts *6 o,-Nr Ofce of Public Safety and Inspections �F SUlL T INSPECTiONg Ma achusetts State Building Code(780 CMR) BuildingPermrt-2419lication for any Building other than a One-or Two-Family Dwelling (This Section For Official Use Only) Building Permit Number:.79- 9,3 Date Applied: Building Official: SECTION 1:LOCATION t Ma:n S - f toranc& MA. O1O64 f toIc nce. Den4lak Cat, No.and Street City/Town Zip Code Name of Building(if applicable) Assessors Map# Block#and/or Lot # SECTION 2:PROPOSED WORK Edition of MA State Code used If New Construction check here 0 or check all that apply in the two rows below Existing Building 0 Repair 0 Alteration Lir Addition 0 Demolition 0 (Please fill out and submit Appendix 2) Change of Use 0 Change of Occupancy 0 Other 0 Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes 0 No 0 Is an Independent Structural Engineering Peer Review required? Yes 0 No 0 Brief Description of Proposed Work: ('GM6Ve-, 5/4,5 4ICcart cab ttll4.S4 t✓atlPIp.e --Trir'1 {eQ14cz a l.t (,) lit nu) SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) 0 Existing Use Group(s): Proposed Use Group(s): SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft) Total Area(sq.ft.)and Total Height(ft) SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1 0 A-2 0 Nightclub 0 A-3 0 A-4 0 A-5 0 B: Business tr. E: Educational 0 F: Factory F-1 0 F2 0 H: High Hazard H-1 0 H-2 0 H-3 0 H-4 0 H-5 0 I: Institutional I-1 0 I-2❑ I-3❑ I-4❑ M: Mercantile 0 R: Residential R-10 R-2 0 R-3 0 R-4 0 S: Storage S-1 0 S-2 0 U: Utility 0 Special Use 0 and please describe below: Special Use Description: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA 0 IB ❑ HA IIB 0 'HA CI IIIB ❑ IV 0 VA 0 VB 0 SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item) Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit: Debris Removal: Idi Public A trench will not be Licensed Disposal Site Check if outside Flood Zone}' Indicate municipal O required�'or trench or specify: Private 0 or indentify Zone: or on site system 0 permit is enclosed 0 9a1nt( c t..t UUii gyp'j *�•� Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process: �K Not Applicable cr Is Structure within airport ap roach area? Is their review completed? or Consent to Build enclosed 0 Yes 0 or NoW Yes 0 No lir SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Group(s): Type of Construction: Does the building contain an Sprinkler System?: _ Special Stipulations: Design Occupant Load per Floor and Assembly space: --IISECTION 9: PROPERTY OWNER AUTHORIZATION .Name and Address of Property Owner 'Grcibc 'i . !K 4s# Gitn accit L tons m e aad9w 0006 \ame(Print) No.and Street City/'mown /'F Property Owner Contact Information: __ utiVMy"31 g fion+-de h sf1 orcenc ,re,, Title Telephone No.(business) Telephone No. (cell) email address r If applicable,the property owner hereby authorize G kk0"t; N&bi( � Ga�a t &i- Ci'(AC. Loinee►ta AAA olio() 1 7 Name Street Address City/Town State Zip to apply for and act on the property owner's behalf,in all matters relative to work authorized by this building permit application. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 1) If a building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here D. Otherwise provide construction control forms(see section 107 In the code)as required. 10.1 Registered Professional Responsible for Construction Control(the professional coordinating document submittals) Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contractor ) Company Name Name of Person Responsible for Construction License No. and Type if Applicable Street Address City/Town State Zip Telephone No.(business) Telephone No.(cell) e-mail address SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L c.152.§25C(6)) A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents 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. Is a signed Affidavit submitted with this application? Yes C) No 0 SECTION 12.CONSTRUCTION COSTS AND PERMIT FEE Estimated Costs:(Labor Item and Materials) Total Construction Cost(from Item 6)it.$ — 1.Building $ Building Permit Fee=Total Construction Cost x (Insert here 2.Electrical $ appropriate municipal factor)_$ . 3.Plumbing $ 8 Mechanical (HVAC) $ Note:Minimum fee=S (contact municipality) 5.Mechanical (Other) $ _ Enclose check payable to 6.Total Cost $ (contact municipality)and write check number here_______ _ SECTION 11 SIGNATURE OF BUILDING PERMIT APPLICANT 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. Please print and sign name Title Telephone No. Date Street Address City/Town State Zip Email Address Munidpal Inspector to fill out this section upon application approval: I �� �..- jZ zozq Name Crate. SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner Name(Print) No.and Street City/Town Zip Property Owner Contact Information Title Telephone No.(business) Telephone No. (cell) e-mail address If applicable,the property owner hereby authorizes: Name Street Address City/Town State Zip to apply for and act on the property owner's behalf,in all matters relative to work authorized by this building permit application. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 1) If a building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here❑. Otherwise provide construction control forms(see section 107 in the code)as required. 10.1 Registered Professional Responsible for Construction Control(the professional coordinating document submittals) c,Yv\z /lJ44c9LC Lka_�1,3 - pc:A ���RA/Age l3,torn Name Registrant) Telephone No. e-mail address Registration Number �ek a wcc fct- CI1< l - Lan r ' codow AAA- dik,fo Street Address City7Town State Zip Discipline Expiration Date 10.2 General Contractor (A/ ,tq oaeto Company Name - l 36C Name of Person Responsible for Construction License No. and Type if Applicable let Attica L,`rcl-e., L crigrncOdow Aix otr o 6 Street Address City/Town State Zip u121 3 1 1 - - 04 (6 Fog gA'R A ef/c)l i ng, c-d''1 Telephone No.(business) Telephone No.(cell) e-mail address SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L c.152.§25C(6)) A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents 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. Is a signed Affidavit submitted with this application? Yes 0 No 0 SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)=$ 1.Building $ \ 000 .00 Building Permit Fee=Total Construction Cost x (Insert here 2.Electrical $ appropriate municipal factor)=$ 3.Plumbing $ 4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality) 5.Mechanical (Other) $ Enclose check payable to CA-1 CC A/VahanQ 6.Total Cost $ �!COO,CO (contact municipality)and write check number here 10 I O SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT 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 knowled e and understanding. 4111 Na1&u.( Ranajli akiner 3-2J3- lam( Pease aint and sign nme Title Telephone No. Date ek ac.vat ntrn ca.&r4J Ailfr Ott v(o n-1- 412.R cor'1 Street Address City/Town State Zip Email Address Municipal Inspector to fill out this section upon application approval: Name Date The Commonwealth of Massachusetts _ )t�.;p�l,_ Department of industrial Accidents _ 1 Congress Street,Suite 100 f_= Boston, MA 02114-20!7 • ,4;' WwH:mass.gor/dift 11 414 kers'Compensation Insurance Alliidas it:Builders?Contractors.fElectricians/Plumhers. TO BE FILED WITH THE Pi RM TING AUTHORITY. Applicant Information , r n \ Please Print Legibly Name 1liusmos&Organization�individual): /V � Address: ` a h Wct( >S Circle, Lon r i eCJE C,w Mfr.o l.ca City/State/Zip: r\A-P CG 1106 Phone#: ( — 3t3 — [2 O l Are y on an employer?Check the appropriate box: Tv pc of project(required): 7.Q l ant a imtplo r with -------emaployces(foil andr'ot port-timey 7. ❑ New construction 1 am a auk proprietor or pnrtncahip and have no employ era working for rnr in Il.gi Retnode tang • :any capacity.[Nu workers'comp.insurance netloiroJ.) 9. ❑Demolition .30 lam a lunsoonner doing all wank myself.[No workua'curs,.in+oramti requital" 100 Building addition 4.71 I am a humooaner and will tic Erring cxmtr-m.'turs to conduct all work on my pro a.1ty. I will ensure that all co ntr:utun citb.r have workers-curripenaataon Mannino:or arc sole 11.0 Electrical repairs or additions ptuptietura w ith no etttpluyccs. 12E1 Plumbing repairs or additions 5 I ant a general contractor and 1 hnr hired the aub-cuntraeton listed on the attacbcd aheet. Theb-contractor,have employees and have wutkcra'rwnp.insurance. 13.0 Roof repairs w sub-contractor, kr]we a a corporation and its officers have exercised their ngla of exemption per M(L e. 14. ©thee m 1 e2,yt 1 i 41.and we have no employees.[No workers'comp.inaraarwr rcyui ed.] 'Any applicant that cheeks box#1 must also till out du section below shooing than workers'.;otrtpensatiun policy information. °Itotncownen.who subunit this affidavit indicating they arc doing all wink and than hire outside contractors most suMmt a new affudam it indicating soil. :Contractors,ontractora that cheek this box must attached an additional sheet show in the name of the sub-contractors and state a Itether or not those entities have employees. If the sub-contractors base ettt}}luyees.they mini provide their wurkcrs'camp.policy nutnbet. !am an employer that is providing workers'compensation insurance for my employes. Below is the policy and job site iinfornratimi. ` _ f Insurance Company Name: Ai e-'?X� \`S� t\cSe once, C.CQnC,'1 Policy#or Stilt-ins.Lie.#: /`�x 1 Z C, rNt) C -�yL Expiration Date: ( I c I Job Site Address: LA I (no- 11 t fe CityrStatelZip: IJ I C 60)- Attach a copy of the workers"compensation policy declaration page(sho sing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to S1,500.00 and/or one-year imprisonment,as well as civil penalties in the form ofa 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 ot'the DIA for insurance coverage verification. I do hereby certifi under the pains and penalties of perjury that the information provided above is true and correct r Sit•natur: ,� Date: 6 1ggq Phone#: —$13-- �f�-120 ii Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License;x Issuing Authority(circle one): 1. Board of Health 2.Building Department 3.City"Town Clerk 4.Electrical Inspector S. Plumbing Inspector 6.Other Contact Person: Phone*: CONSTRUCTION CONTROL WAIVER From ,JCkn J VA Cam- c C;C( ej LO18r1 'CCU c�c.W C9} C(p To. Building Commissioner City of Northampton 212 Main Street Northampton,MA 01060 The Massachusetts Building Code,section 107.1 allows for an exclusion from requirements for construction control in certain situations.In accordance with code section 104.10,I request that you grant a modification to waive the requirement for construction control of the project at .1< Nu; Sk F 4 U re,iry.,, M N w w ow- because the work is of a minor nature,will not affect structural elements,health,accessibility,life or fire safety,and will be done in accordance with the prescriptive requirements of the code. Thank you for your consideration. Respectfully, i Initial Construction Control Document To be submitted with the building permit application by a Registered Design Professional '�� "s" for work per the ninth edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Date: ( L l 2 Lit tv1CnCe Den-.ot Co(C. Property Address: ►rh a 11 5'r -nor once„ .c4s,t>• d!Oa- Project: Check(x)one or both as applicable: New construction Existing Construction i Project description: e_Yno G exS 9 cc4i e-LS/4 lcoI (°tom 'r wq l(S e e_ L I MA Registration Number: Expiration date: ,am a registered design professional, and I have prepared or directly supervised the preparation of all design plans,computations and specifications concerningl: Architectural Structural Mechanical Fire Protection Electrical [a. ')( c5 P + C- for the above named project and that to the best of my knowledge,T3 information, and belief such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2_ Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent comments,in a form acceptable to the building officiaL Upon completion of the work,I shall submit to the building official a 'Final Construction Control Document'. Enter in the space to the right a"wet" or electronic signature and seal: Phone number: Lt t3- Idol Email: I n f' (�Vg6-ems s , co /1 Building Official Use Only Building Official Name: Permit No.: Date: Note 1.Indicate with an'x' project design plans,computations and specifications that you prepared or directly supervised_If'other' is chosen,provide a desorption Version O1 O1 2018 City of Northampton �SNAM a� < 2 ,Qt Massachusetts ��,:• 0 * I • DEPARTMENT OF BUILDING INSPECTIONS �' 212 Main Street • Municipal Building vd. 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: D Lon? 41141Ie Location of Facility: af1d L) nockel,lcoS ar1ia reco/C l J- 38 Fak,rner UveI weS - SPr,'o , 1,c)/ M. OSCI The debris will be transported by: 6 Z i u it-CAA r Name of Hauler: �� N \6401&is Date: G/I Signature of Applicant: �y AIC ® DATE(MM/DD/YYYY) v CERTIFICATE OF LIABILITY INSURANCE 09/15/2023 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 NAME: — Next First Insurance Agency,Inc:. PHONE (855)222-5919 FAX PO BOX 60787 (AlC.No.Eatt): (A/C,No): Palo Alto,CA 94306 E-MAIL ADDRESS: support@nextinsurance.com INSURERS)AFFORDING COVERAGE NAIC# INSURER A: Next Insurance US Company 16285 INSURED INSURER B: Ramzi Natour INSURER C =2NR Remodeling )Edward Cir INSURER D: ongmeadow,MA 01106 - INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:986600547 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 SUBR POLICY EFF ' POLICY EXP W UNITS LTR INSD VD POUCY NUMBER (MM/DDIYYYY) IMM/DD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000.00 AMAGE TO CLAIMS-MADE X OCCUR PREM PREMISES(EaENTED occurrence) $100,000.00 MED EXP(My one person) $15,000.00 A NXTA2OTRNO-04-GL 09/15/2023 09/15/2024 PERSONAL&ADV INJURY $1,000,000.00 GENL AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2,000,000.00 I POLICY PO- JECT LOC PRODUCTS-COMP/OP AGG $2,000,000.00 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED — SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DBE $ AUTOS ONLY AUTOS ONLY (Per accident) $ UMBRELLALJAB OCCUR EACH OCCURRENCE $ _~ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Each Occurrence: $25,000.00 A Contractors Errors and Omissions NXTAZOTRNO-04-GL 09/15/2023 09/15/2024 Aggregate: $50,000.00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Proof of Insurance. CERTIFICATE HOLDER CANCELLATION Ramzi Natour LIVE CERTIFICATE RNR Remodeling 0 r: J• SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 19EdwardCir ,.J-.iJ THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Longmeadow,MA 01106 '' -c- r ACCORDANCE WITH THE POLICY PROVISIONS. 02 A i. ...lc' 4,-- AUTHORIZED REPRESENTATIVE • ff M; '� Click or scan to view ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD �1 ® CERTIFICATE OF PROPERTY INSURANCE DA2323 DD/YYYY) ACORN S�2 J Z s C 9!' 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. PRODUCERNext First Insurance Agency,Inc. NAMEACT PO Box 60787 Palo Alto,CA 94306 (A/C.PHONE Extt:(855)222-5919 FAX No): E-MAIL Or[ ADDRESS: SU pP @nextinsurance.com PRODUCER CUSTOMER ID: INSURER(S)AFFORDING COVERAGE NAIC# INSURED Ramzi Natour INSURERA: State National Insurance Company,Inc. 12831 RNR Remodeling 19 Edward Or INSURER B: Longmeadow,MA 01106 INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 986600547 REVISION NUMBER: LOCATION OF PREMISES I DESCRIPTION OF PROPERTY (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTVVITHSTANDING 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 POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION COVERED PROPERTY LIMITS LTR DATE(MM/DD/YYYY) DATE(MMIDD/YYYY) PROPERTY — BUILDING $ CAUSES OF LOSS DEDUCTIBLES PERSONAL PROPERTY $ BASIC BUILDING BUSINESS INCOME $ BROAD CONTENTS - EXTRA EXPENSE $ SPECIAL - RENTAL VALUE— $ EARTHQUAKE BLANKET BUILDING $ WIND - BLANKET PERS PROP $ FLOOD - BLANKET BLDG&PP $ $ X I INLAND MARINE TYPE OF POLICY X EQUIPMENT $3,000.00 CAUSES OF LOSS Contractors Equipment X MISC TOOLS $600.00 A 06/16/2023 06/16/2024 NAMED PERILS POLICY NUMBER X BORROWED TOOLS $3,000.00 X OPEN PERILS NXTPW9H97L-01-IM $ CRIME $ TYPE OF POLICY $ IBOILER&MACHINERY I $ EQUIPMENT BREAKDOWN $ SPECIAL CONDITIONS I OTHER COVERAGES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) Proof of Insurance. CERTIFICATE HOLDER CANCELLATION Ramzi Natour LIVE CERTIFICATE RNR Remodeling ..%itiu❑ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 19 Edward Cir r.. • J THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Longmeadow,MA 01106 ACCORDANCE WITH THE POLICY PROVISIONS. .4t 4.• . 4-I'rti• 4 AUTHORIZED REPRESENTATIVE 0 •q, C Click or scan to view ©1995-2015 ACORD CORPORATION. All rights reserved. ACORD 24(2016/03) The ACORD name and logo are registered marks of ACORD Commonwealth of Massachusetts Division of Occupational Ucensure Board of Building Nulations and Standards • Const vsnueuttiovisor CS-113691 eipires:01/13/2025 RAMZIJ NA 0 R' 19 EDWARD' LONGM • .* 0 rilanftliP • Commissioner de. Kewirnewepevr/ fyr. Office of Consumer Affairs&Business Regulation itifOPCIVFLIFIAIT CONTRACTOR Registration valid for Individual use only