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13-057 (2) BP-2024-1115 31 MARIAN ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 13-057-001 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-2024-1115 PERMISSION IS HEREBY GRANTED TO: Project# ROOF/SKYLIGHTS 2024 Contractor: License: WILDE HSE LLC DBA SEXTON Est.Cost: 39567 ROOFING 106265 Const.Class: Exp.Date:03/08/2027 Use Group: Owner: FOTI MELODY A TRUSTEE Lot Size (sq.ft.) Zoning: Rl/SR Applicant: WILDE HSE LLC DBA SEXTON ROOFING Applicant Address phone: Insurance: 45 OLANDER DR 315-569-7761 6HUBOW551 13924 NORTHAMPTON, MA 01060 ISSUED ON: 09/06/2024 TO PERFORM THE FOLLOWING WORK: STRIP AND RE-ROOF, INSTALL 2 SKYLIGHTS POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. I3oildin„; Inspector Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Final: Final: Final: Rough Frame: (:as: 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,__72_ Fees Paid: S120.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner 0 1:? C The Commonwealth of Massach efts 4/1, 'Lt Board of Building Regulations and tan rds i Massachusetts State Building Cod 789,pp 29 F 202� S AL1TY Building Permit Application To Construct,Repair, t ,pt ish a evis d Mar 2011 One-or Two-Family Dwelling A1'7'0 iNspFcn lvs This Section For Official Use Only o'06( Building Permit Number: d A -///5' Date Applied: Sa1/� IC/j4G jgo =�` Building Official(Print Name) gnature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 31 miN lZ1 4\1J T. 1.2 Assessors Map& Parcel Numbers (yOR'-r-ki.Avvs_c‘-o 1 mys. 0 I 0(ob 1.1 a Is this an accepted street?yes t/ 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� Private❑ Zorn: _ Outside Flood Zee? Municipal B'On site disposal system 0 Check if yes SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: / c`n 1.-.0 O' .� 1J0f i4'cP Meiht e . aIptoC) Name(Print) v City,State,ZIP A i`k- k - . 6 i 3,1O-'19co F Ti . Al EL-00 Vc@arivkIL.CDrn No.and Street Telephone Email Addre SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction❑ Existing Building 111' Owner-Occupied 6' Repairs(s) Eri Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work2: t - 1 R -UAS 1.1 c t i 1►-�s,-a tA, NV-v.) C1u'R'L(.S 1 4,:)Birk U._ 2 St4LI COATS SECTION 4:ESTIMA CTION OSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 39 5-6 7.of 1. Building Permit Fee:$ Indicate how fee is determined: 2.Electrical $ 0 Standard City/Town Application Fee ❑Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Suppression) Total All Fees: $ (�}} 0Check No. "Check Amount: �0 Cash Amount: 6.Total Project Cost: $3q 56,7,TO 0 Paid in Full 0 Outstanding Balance Due: r SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) /b c,� 5�� t� � License! Expiration Date Name of CSL Holder ,p OL��� �� List CSL Type(see below) 1\ No.and Street Type Description U Unrestricted(Buildings up to 35,000 cu.ft.) cc-T'kt.`M p o 1 0 1 ( ci C) R Restricted l&2 Family Dwelli g City/Town,State,ZIP - M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 4_q1554-I 134 S E X 1 a tJ-OCR l -1��F)�g I Insulation elephone _ Email address tw d .Ct v4 D Demolition 5.2 Registered HomeImprovement Clootractor(HIC) t2as, 1 tic) id3O/2 s-- c D`tJ eit) 11• l L7 ,t6 HIC Registration Number Expiration Date HIC Company Name or I IIC Registrant Name 5EV a I)e.( l tC-t tM)C GynAl L. Co O1 No.and Street Email address 1 t) �, mom. ( )_CO 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,as Owner of the subject property,hereby authorize 1t�p•0 RoeR 11 to act on my behalf,in all matters relative to work authorized by this building permit application. fe jaiPrint Owner's Name(Electronic Signature) Da 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. V9itt 6/./2-pe s?/...04 //,ez P `Yrrar Owner's or Authorized Agent's Name(Electrons Signature) ate 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. 142k 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.govidps 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 halflbaths 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 \ / iy''� Massachusetts ��5 �. f', F I w Y L .1 ( i f• • DEPARTMENT OF BUILDING INSPECTIONS y �j° `Z°, *.. < � 4` 212 Main Street • Municipal Building v/ bD i,f111,1 Northampton, MA 01060 'rst Jy �,0 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 ps�- Location of Facility: 3sa k.LfrAtt al.. pczi+JC-171 Z,1c) r1'& 011Os The debris will be transported by: Name of Hauler: 45c/47p /.IIa71/I( /4.) Z s 1,,JC• , Signature of Applicant: ,./1 Date: d.,74/.,77 The Commonwealth of Massachusetts 1t M.;, immi(l, Department of Industrial Accidents _ �= 1 Congress Street,Suite 100 _ 1t Boston,MA 02114-2017 www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plun►bers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name(Busincss/OrganizationMdividual): Sexton Roofing&Siding Address: 45 Olander Dr. City/State/Zip: Northampton, Ma 01060 phone #/: 413-534-1234 Are you an employer?Cheek the appropriate box: Type of project(required): LQ I am a employer with employees(full and/or part-time).* 7. ❑New construction 2.�I am a sole proprietor or partnership and have no employees working for me in t. p Remodeling any capacity.[No workers'comp.insurance required.] 3.0 I am a homeowner doing all work myself.[No workers'comp.insurance required.], ❑Demolition 4.0 I am a homeowner and will be hiring contractors to conduct all work on my property. i will 10 Building addition ensure that all contractors either have workers'compensation insurance or arc sole I I.E3 Electrical repairs or additions proprietors with no employees. 12.Q Plumbing repairs or additions s.0 i am a general contractor and 1 have hired the sub-contractors listed on the attached sheet. (3. Roof repairs These sub-contractors have employees and have workers'comp.insurance.: t,.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. if the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Travelers Policy#or Self-ins.Lic.#: U B-0W551139-24 Expiration Date: 6/1/25 Job Site Address: 31 Marian St. City/State/Zip:Northampton, Ma 01060 Attach a copy of the workers'compensation policy declaration page(showing 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$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.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 ab ve is true and correct. Si nature. Date- efr- c:24 - Phone#: 413-534-1234 Official use only. Do not write in this area,to he completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.CityTl'o►cn Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) tL� 06/05/2024 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: ORMSBY INSURANCE AGENCY (NC. Nu Ext): (413)737-0300 FAX (A/C No): E Al AIL ADDRESS khutchinson �•COm AD P O BOX 718 INSURER(>S�AFFORDING COVERAGE SACS WEST SPRINGFIELD MA 01090 NouREA A; TRAVELERS INDEMNITY CO OF AMERICA 25666 INSURED INSURER B: WILDE HSE LLC INSURER C: INSURER D: 45 OLANDER DRIVE INSURER E: _ NORTHAMPTON MA 01060 INSURER F: COVERAGES CERTIFICATE NUMBER: 1014749 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 POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POUCIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ICY EFF POLICY EJCP N TYPE OF INSURANCE POLICY MJ Mt (WNW-AM11/00/YYYY) AralWYYYM UNITS COMMERCIAL GENERAL UABLITY EACH OCCURRENCEAMAGE TO RENTED-- S CLANS-MADE OCCUR PREMISES Ea occurrence) S — MED EXP(Any one person) S N/A PERSONAL&ADV INJURY $ GEM AGGREGATE UNIT APPLES PER GENERAL AGGREGATEPRO- S POLICY JECT []LOC PRODUCTS.COP AGS S OTHER: AUTOMOBILE LIAB&ITY COMBINED SINGLE LIMIT $ (Ea aocidenm ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED N/A BODILY INJURY(Per acddent) S AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Peracddeel) S UMBRELLA LNB OCCUR EACH OCCURRENCE S EXCESS LIAR CLAIMS-MADE N/A AGGREGATE $ LICD I RETENTIONS S -- - — WORKERS COMPENSATION X OTH- PEERTUTE ER AND EMPLOYERS LIABILITY ANYPROPRIETORIPARTNER)EXECUTIVE IY(N EJ_EACH ACCIDENT $ 1.000,000 A OFFICER/MEMBEREXCLUDED? I I WA NIA 6HUBOW55113924 06/01/2024 06/01/2025 (Mandatory in NH) E.L.DISEASE-EAEMPLOYEE i 1,000.000 Byes describe under 1,000,000 DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY Law S N/A DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule.may be attached If more apace 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 dale 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.govfwd/workers- compensalion/investgations/. 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 City of Northampton ACCORDANCE WITH THE POLICY PROVISIONS. 212 Main Street AUTHORIZED REPRESENTATIVE Northampton MA 01060 LI)"f Daniel M.Crowley,CPCI), 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 IACC0REi CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 06/03/2024 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 Amanda Cordeirc NAME: Clayton Insurance Agency,Inc PHONo,Ext): FAX(413)536-0804 F No): (413)534-7874 1649 Northampton Street E-MAIL prnrdeiro daytnnlnsuranrn not ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC a Holyoke MA 01040 INSURER A• Submissions INSURED INSURER B Safety Insurance Company 0014 Wilde HSE LLC,DBA:Sexton Roofing 8 Sidinc INSURER C 45 Olander Drive INSURER D INSURER C Northampton MA 01060 INSURER F COVERAGES CERTIFICATE NUMBER: CL246306545 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOC INDICATED. NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIE 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-SUERPOLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DDIYYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 5 1,000,000 DAMAGE TO R CLAIMS-MAUL X OCCUR PREMISES(EaENTED occurrcxxx) $ 100,000 MED EXP(Arty one person) $ 10,000 A BND0016953 05/30/2024 05/30/2025 PERSONAL&ADV INJURY $ 1,000,000 GEM.AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 POLICY n JECT LOC PRODUCTS-COMP/OP AGG $ 2.000.000 OTHER S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ H OWNED X SCHEDULED 5935264 05130/2024 05/3012025 BODILY INJURY(Per accident) S AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE S X AUTOS ONLY X AUTOS ONLY (Per accident) Medical payments $ 5,000 UMBRELLA LIAR OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RLILNIION$ $ WORKERS COMPENSATION PER 0tH- AND EMPLOYERS'LIABILITY Y I N STATUTE ER ANY PROPRIETOR'PARTNEREXECUTIVE 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 $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may bo attached it more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN THE CITY OF NORTHAMPTON ACCORDANCE WITH THE POLICY PROVISIONS 212 MAIN StREET AUTHORIZED REPRESENTATIVE NORTHAMPTON MA 01060 �6P.tr..r P �� 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 8/26/24, 10:12 AM IMG20240510065637.jpg The Commonwealth of Massachusetts I` !1 Department of Industrial Accidents _M111= 5 I Congress Street,Suite 100 3 pi=s* Boston,MA 02114-2017 "::_I' www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Auolicant Information Plsaas Print Legibly Name(Business/Organizationnndividual): MTA CTYrletka (O(t t t WO COI Address: l0 4h5 <k Apt a- _ -_-- CityiStateiZjp: M].k NON (5(15-1 Phone#: tia 1 1410 3 449 Ajaau employer?Check the appropriate bus: Type of project(required): 1. am a employer with employees(full and/or pun-time).• 7. 0 New construction 2.01 am a sok proprietor or partnership and have no employees working for me in 8. El Remodeling any capacity.[No workers'comp.insurance required.] 3.01 am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. Demolition 4.01 am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 0 Building addition assure that all contractors either have workers'compensation insurance or arc sole 11.1=1 Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5.0I am a general contractor and I have hired the sub-contractors listed on the attached sheet. Thesesub-contractors have employees and have workers'comp.insurance.: 13.DR'oof repairs 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.Q Other__ 152,§1(4),and we have no employees.[No workers'comp.insurance required.] 'Any applicant that checks box k I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that chock this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: TcT vf-te.1f'S Pfti fcC4j (C1S (n QF AM Policy#or Self-ins.Lic.#: �3c1SSt-1 Expiration Date: 9 13p 12.(3).5 Job Site Address: r ) ` 1 ACZ-1{‘.. 1 1 . City/state/Zip:_ot-c A ) mA 01 ( Attach a copy of the workers'compensation policy declaration page(showing the policy number and expidate). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to 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: /Gra. Ali -- Date:05/O y / `LD 2# Phone#: 1/01-tl fa 3H'19 Official use only. Do not write in this area,to be completed by city or town official a City or Town: Permit/License# Issuing Authority(circle one): , 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: I httpsj/drive.google.com/drive/folders/1ZyXGHtu68J3njf9-oHbp9M-yfWgOXr9u 1 '' Ace CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 05/09/7074 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 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 GUILHERME CAMOSSATO NAME: _ I-INSURANCE GROUP INC PHONE (978)645 6996 FAX (A/C.No.Eat): (A/C,No): 799 GORHAM Si -UNIT A E-MAIL info@su ce i-inran net ADDRESS: grou P LOWELL,MA 01852 INSURER(S)AFFORDING COVERAGE NAIC INSURER A; ATLANTIC CASUALTY INS CO INSURED INSURER B: TRAVELERS PROPERTY CAS CO OF AM MJA GENERAL CONSTRUCTION CORP INSURERC: 6 OTIS STREET INSURER D: APT 2 INSURER E• MILFORD MA 01757 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 ADDL LTR INSR WVD POLICY NUMBER BR POLICY EFF POLICY EXP LIMITS TYPE OF INSURANCE LMWt)OlYYYY) LMWDD/YYYY) ______ GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000.00 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 100,000.00 PREMISES(Ea occurrence) $ CLAIMS-MADE X OCCUR MED EXP(Any one person) $ 5,000.00 A L261008542-0 05/03/2024 05/03/2025 PERSONAL&ADV INJURY $ 1,000,000.00 GENERAL AGGREGATE $ 2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 2,000,000.00 POLICY n PRC-JET LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) , $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU OTH- AND EMPLOYERS'LIABILf'Y Y TORY LIMITS ER tie ANY OFFICCER'MEMB XCLLUD D?ECUTIVE N N I A ASSIGN#1397554 04/30/2024 04/30/2025 E L.EACH ACCIDENT $ 1,000,000.00 (Mandatory in NH) E L.DISEASE-EA EMPLOYEE $ 1,000,000.00 If yes,describe under 1,000,000.00 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,It more space is required) General I lability:for regular and usual jobs.Worker's Compensation. MA employees only. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Wilde HSE,LLC DBA Sexton Roofing and Siding Co THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 45 Olander Dr Northampton MA 01060 AUTHORIZED REPRESENTATIVE GUILHERME CAMOSSA I O ACORD 25(2010/05) n 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Licensee Details Demographic Information Full Name: SASHA MARIE WILDE powner Name: License Address Information City: NORTHAMPTON State: MA Zipcode: 01060 Country: United States License Information icense No: CSSL-106265 --Tice n se Type: Construction Supervisor Specialty rofession: Building Licenses Date of Last Renewal: Issue Date: 7/6/2023 Expiration Date: 3/8/2027 icense Status: Active Today's Date: 7/7/2023 econdary License Type: oing Business As: tatus 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 Typo LLC - Registration 2oiseo 1v LDE►SEE.LLC � Expiration Oag42025 D B A SEXTON ROOFING E SONG = cS0.4ADERDR NORTMAAAPTON.MA 03104 ' •—� \mix- ,1A, 01; upaats Address a-d Rstur-C. THE CO4NOW*IALT11 OI MA$$ACNu$ETTS ONIa el Cenewrier Albs L Duct**,Rs5utagen R.01at►ation vaad for lndlvtduat us.Only es/ors t••s NOME 111111140111MENT CONTRACTOR •apksNen dale. N round return le TYR:LLC ONlea M Consume,Affairs and busmsss Regulate,' t00$waIlnpten Street •Suits 710 2011470 04+3 Saeloo,IAA 031111 W&DE•ODE LLC D b'A Stx1 ON 14000 WG♦1110440sAsm OL A WILDE aS Ot/�rg le I aS ER OR �,r,,.A ./6rA — ---. tyORTNAAAPTON•MA 01104 i.k100,1100riatary Not valid without signature SEXTON ROOFGUARD Description Line total Sexton RoofGuard 1.Strip and remove existing shingles and dispose of in proper landfill. $21,305.00 2.Inspect roofing deck and re-nail any loose decking. If replacement is needed due to rot, de-lamination,or damage,the following prices will be charged: @$100 per sheet for 1/2"CDX @$125 per sheet for 3/4"CDX 3.Install new metal edging to rakes and eaves of roof.(white/brown). 4. Install leak barrier protection 6 feet up on eaves,around vent stacks, in valleys,around chimney and at all places where roof intersects with walls or other roof facets. 5.Install roof deck protection on remainder of roof. 6.Install new flashing over existing vent stacks. 7.Install starter shingles on eaves and rakes of roof. 8.Install IKO Cambridge Architectural roofing shingles as per manufacturers'specifications. 9. Install new cap over ridge vent. Warranties to be provided after final payment: IKO Lifetime warranty including 10 years IronClad SRC 10 yr.workmanship warranty Rehash chimney(price included) Replace two skylights with Velux Fixed M06 and install Velux flashing kit $2,900.00 Estimate subtotal $24,205.00 Total $24,205.00 SEXTON ROOFGUARD PREMIUM Includes everything from Sexton RoofGuard $24,205.00 Description Line total Sexton RoofGuard Premium 1. In place of Cambridge shingles, install Dynasty Performance. $5,419.00 For those seeking a more premium option,the Dyansty shingle is available as an upgrade over the Cambridge.In addition to a class 3 impact rating for hail damage, Dynasty can also withstand winds up to 130MPH.This performance,combined with high definition colors,enhances your home's protection, curb appeal and resale value. Warranties to be provided after final payment: IKO Lifetime warranty including 15 years IronClad SRC 10 yr.workmanship warranty Estimate subtotal $29,624.00 Total $29,624.00 SEXTON ROOFGUARD ELITE Includes everything from Sexton RoofGuard $24,205.00 Description Line total RoofGuard Elite RoofGuard Elite is a program developed in conjunction with IKO and can only be executed by Sexton $10,002.00 Roofing and Siding,an IKO Craftsman Premier roofing contractor.Sexton Roofing and Siding is the ONLY Craftsman Premier contractor in the Pioneer Valley. 1.All materials installed on the roof are IKO's premium offerings and include the following mandatory upgrades: a.IKO GoldShield Premium Ice and Water Protector,installed 6 feet up on eaves,around vent stacks, in valleys,around chimney and at all places where roof intersects with walls or other roof facets. b.Install IKO GoldSeam.To be installed on all eaves to cover gaps between roof and fascia board. To be installed over all intersections of plywood decking. In the case of a roof having barn board or other substrate,full roof coverage of IKO GoldShield to be applied. c.IKO Stormtite to be installed on remainder of roof. d.IKO EdgeSeal on all eaves and rakes. 2.In place of Cambridge shingles,install Dynasty Performance. 3.Upgrade to Ultimate pipe flashings(Manufacturer warranteed for the life of your roof). Warranties to be provided after final payment: IKO Lifetime warranty including 25 years IronClad SRC 15 yr.workmanship warranty The following conditions must be met to qualify for the RoofGuard Elite program: 1.The attic is properly vented according to the highest of either ARMA/CASMA,IKO or local building code requirements.A properly balanced ventilation system requires ridge,static vents and under-eave or soffit ventilation,and per ARMA's/CASMA's requirements,the vents shall be uniformly distributed on opposite sides of the building in such a way that approximately 50%are near the lower part of the roof(inflow),and approximately 50%are near the ridge(outflow). 2.Installation must be on a clean,dry and stable roof deck without any of the previous Shingles or roofing materials remaining on the roof.(Note:Installation of Shingles directly over an existing layer will void the ROOFPRO Select or Craftsman Premier Limited Warranty extension of an additional 10 years.) 3.Valid only on complete single-family dwelling residential roofing applications with a minimum roof area of 10 squares,a maximum roof area of 100 squares and a roof pitch of 3:12 or steeper.Please note that enhanced installation requirements apply to slopes between 3:12 to 4:12. Estimate subtotal $34,207.00 Total $34,207.00 SKYLIGHT QUOTE (YES) Sexton Roofing and Siding strongly suggests that you replace your skylight(s)during the re-roof process.Skylights 10 years and older typically are no longer warranted by the manufacturer,and simply re-flashing the existing skylight(s) does not guarantee a watertight installation. New VELUX Skylights feature a number of advanced energy-efficient design features,including LowE-3 glass and several solar-powered shade options.VELUX Deck Mount and Curb Mount Skylights installed with an approved VELUX flashing kit come with an industry leading Manufacturer 10-YEAR NO LEAK PRODUCT AND LABOR WARRANTY. Yes,I would like to replace my Skylights. Initial Here: IMF. T W AUTHORIZATION PAGE ❑ Sexton RoofGuard $24,205.00 Name: Melody Foti ❑ Sexton RoofGuard Premium $29,624.00 Address: 31 Marian St., Northampton, MA © Sexton RoofGuard Elite $34,207.00 NOTE:Quote valid for 30 days from date of estimate.1/3 deposit due at signing via cash,check,or ACH deposit. Description Line total © Gutters are an essential element to a well-protected home.They direct rainwater away from the $3,170.00 foundation, preventing water damage,erosion,and basement flooding. By channeling water efficiently,gutters help protect the structural integrity of the house and maintain the longevity of its exterior surfaces. Replace gutters with new 5" K-style seamless gutters and downspouts. Q Gutter guards ensure the gutters function effectively, reducing the need for frequent cleaning and $2,190.00 maintenance while protecting the home from water damage and costly repairs.Stop getting on dangerous ladders to clean your gutters,we're happy to install new gutter guards while we are on your roof. Quote $34,207.00 Options $5,360.00 Final Price $39,567.00 Customer Comments / Notes Melody Foti: ✓fie.0-(§A F04, Date:8/20/2024 Timothy Wilde: Tuiw- u,7 WtiL Date:8/20/2024 9/5/24,2:35 PM Velux Skylight U Value.jpg Ina Glass Description Laminated (VELUX Glazing Code) (04) Thermal Performanc. U-Factor (Btu/hr•ft''•'F) 0.44 SHGC 0.26 VT 0.60 UV Protection % 99.9 (300-380 nm) Fading Protection % Krochmann Damage Function 83.1 (300-600 n m) https://mail.google.com/mail/u/O/#inbox?projector=1 1/1