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44-010 (2) Cae ;aaaasaapun VOW VIN `3T11ANV'clS �j 'Qa NIVA 90b6 113NSdH G NOUon81SNOO SNOS � `d84 ZWZAZ /1: :uogegdx3 � mgm. :adA_L LOb9£L :uol ;ea ;sl6ay — _ N013"INOOlN3W3A0ZIdWl3WOH" _ uoggn %ag ssau!sQg 2p sainjI y aaudnsu03 ;o aa910 y�%.n�'lii% ✓Grit' ���- y'' � �Jfv� ✓�o:/.�1,�,� � �. .. +�p� L�> iL 17L �� ti - IJz,y .._ 11 7 1 li <s Y.1 3iL ti7�Si i U 1 tl i; IJi �Lldd i . ice 82630 Restr+c -ea :o_ 00 A" RONALD W HASKELL { 1406 MAIN ROAD GRANVILLE, MA 01034 _zp,ra[,c,,: 1r1812012 ( a3s1�i..i33r T ^: 13509 DATE (MMIDD/YYYY) - 7 A D CERTIFICATE OF LIABILITY INSURANCE 07/01/2011 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Applied Risk Insurance Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 10825 Old Mill Rd HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Omaha, NE 68154 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. (877) 234 -4420 _ INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Continental Indemnity Co. 28258 Haskell, Ronald W. INSUR B. 1406 Main Rd INSURERC Granville, MA 01034 -9722 INSURERD. CTL 1273 570975 INSURER E: COVERAGES 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 CONTRACTOR 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. AGGREGATE LIMITS SHOW M_ AY HAVE BEEN REDUCED BY PAID CLAI IN Dp'L POLICY EFF TIVETPOLICY EX (RATION LTYt 'SR TYPE- OF INSURANCE POLICY NU . SER DATE MMIDIVYY DATE MMIDOMf' LIMITS GENERAL LIABILITY EACH OCCURA N D CE $ COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurence) $ CLAIMS MADE F OCCUR MED EXP an one arson) $ RSONAL & ADV INJURY $ NERAL AGGREGATE $ PE j GE GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ POLICY PRO- i LOC JECT AUTOMOBILE LIABILITY i COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) 1 ALL OWNED AUTOS BODILY INJURY (Per person) $ SCHEDULEDAUTOS HIRED AUTOS BODILY INJURY NON -OWNED AUTOS (Per accident) $ ----- PROPERTY DAMAGE $ f (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ r ANY AUTO OTHER THAN EA ACC $ I AUTO ONLY: AGG $ EXCESS /UMBRELLA LIABILITY EACH OCCURENCE $ OCCUR CLAIMS MADE i t AGGREGATE $ J $ - -- - DEDUCTIBLE j $ RETENTION $ $ WORKERS COMPENSATION AND _ TQRYLI v!ITS _�S { EnSPLOYEn� LIAFaiL^'Y X C A 1.___ A ANY PROPRIETOR /PARTNER/EXECUTIVE 46- 806566 -01 -03 10/25/10 10/25/11 E.L. EACH ACCIDENT $100,000 OFFICER /MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $100, If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $500,000 OTHER DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION _ - DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES AUTHORIZED REPRESENTATIV '-- 1783118 ACORD 25 (2001/08) © ACORD CORPORATION 1988 1(7/13/2011 08 :17 4137318255 \1! BATESFULLAM WEST SPF PAGE 01/01 AIOR�� CERTIFICATE OF LIABILITY INSURANCE DATE(MMI DD/YYYY) 7/1/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER- THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED 19Y THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the Certificate holder is an ADDITIONAL INSURED, the pollcy(les) 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 endorsements). PRODUCER OMENTACT Sonia Claudio : Rates Fullam Ineuranca Agency, Ina PH (413)737 -3539 A (913)731 -825 EMAIL ,sc1audiQ @bateafullam.com 110 Elm Street INSURERS AFFORDING COVERAGE NAIC # West Springfield MA 01089 INSURERA :Travelers Indemnity of America 25666 INSURED INSURER 13 itionzLl Grange Mutual 14788 Ronald W, Haskell INSURERC; DBA: R. H, & Sons Construction INSURER 0: 1406 Main Road INSURER E: Granvillo MA. 01034 INSURER F' COVERAGES CERTIFICATE NUMBER. revision REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED APOv= FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT VVITH 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. I TT , TYPE OF INSURANCE POLICY NUMBER POLICY EFL M P m Y P YYi LIMITS GENERALLIABILITY EACH OCCURRENCE $ _11000,000 �f MEKCIPkL GENERAL LIABILITY DAMA E 300 , 00 A AIM9 F OCCUR 16804792Xd6g /29/2011 /2312012 MED EXP An ore Demon' $ 5,000 PERSONAL & ADV INJURY 9 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG S 2, 000 , 00 0 X POLICY PRO- LOG I �' AUTOMOBILE ABILITY ri t n} 51NC , LE LIMIT LIABILITY $ 1 1 000,000 B ANY AUTO BODILY INJURY (Per pemon) S ALL OWNED X SCHEDULED 9s70626 /20/2017 /2012012 BODILY INJURY (Per accident) $ AUTOS AUTOS NON - OWNED PERTY DAMAGE $ X HIRED AUTOS X AUTOS ccident Unin»ulRd rnoto-nzt combined $ UMBRELLA LIAR OCCUR EACH OCCURRENCE S EXCESS UAB H OLAIMS-MADE AGGREGATE $ DPD RETENTION $ $ WORKERS COMPENSATION to be sent directly by Co wC STAT U- OTH- L,M AND EMPLOYERS' LIABILITY _ YIN ANY PROPRIETORIPARTNER)EX£CUTIVE ❑ NIA E.L. EACH ACCIDENT S OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE S _ IT r ,dercribu under EL DISEASE- POLIC,YLIMIT S DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS! VEHICLES (Attacn ACORD 101, Additiolal Remarks SFhadulc, K more apace iE reyUlretl) Interior CarpQntry It is agreed and understood Home Depot USA, Tna Its parent, affiliates and subsidiaries are listod as additional insured with respects to liability caused by operations performed by the named insured. CERTIFICATE HOLDER CANCELLATION (1377) 8135 -0694 SHOULD ANY OF THE ABOVE DESCRIBE0 POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. - AUTHORIZED REPRESENTATIVE E Bates, Jr. Acc Exec ACORD 26 (2010!05) (9) 1988 -2010 ACORD CORPORATION. All rights reserved. INS025 (201 The ACORD name and logo are registered marka of ACORD Any alteration or deviation from above specifications involving extra charges will be executed only upon written order, and will become an extra charge over and above the estimate. All workmanship will be warrantied for 1 year from the date of completion. Any unforeseen damage or any unforeseen situations caused by previous remodel projects that are out of our control will be charged at a time and material rate of $65.00 per hour to repair before we can proceed with our portion of the project. Customer right of cancellation is 3 business days from the day the contract is signed by the customer. A1, A Contractor's signature date t ^` custo r '�gnature date v XFINITY Connect suzshoe@c:omcast.net Font Size - RE: windows From : Ron Haskell <ron_haskell @rhandsons.net> Wed, Aug 31, 201112:42 AM Subject: RE: windows To : suzshoe @comcast.net Suzanne, here is the contract Ron R.H. & SONS CONSTRUCTION RON HASKELL OWNER 1406 MAIN ROAD GRANVILLE MA. 01034 PHONE: 413 - 357 -9929 FAX: 413-357-9991 MA REGISTRATION NO. 136407 MA LICENSE NO. 082630 Suzanne Schuster 409 Rocky Hill Rd Northampton, Ma. 01062 413 -584 -3004 suzshoe @comcast.net Window pricing: 1. 16,each double hung windows from Harvey building products style will be the Tribute series they will be painted burgundy on the outside and white on the inside. They will all have full screens with the standard limit lock. They will also meet energy star rating. Kitchen picture window white on the inside burgundy on the outside with High performance glass. 2. We will provide the cedar exterior trim and the primed finger jointed colonial casing for the inside which will be installed picture frame style. 3. Customer will be responsible for the painting and staining of the interior and exterior of the trim. 4. Contractor will ,dispose of all debris S. Contractor will handle all permits. 6. Windows will be set up for 2x6 construction with primed extension jambs. Total price $18,534.60 $10,000.00 deposit to order the windows $6000.00 the day we start $2534.60 due upon completion SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor 1 , Not Applicable ❑ Name of License Holder (mom\ W - �5 g a 6 3 6 License Number (� iM 1��. ��A� ✓" 61 b3LI I 12> 2012 Address Expiration date 1 - Signature Teleph 9. Registered Home Im Contractor: Not Applicable ❑ e ? - 4' 1 2 ,S �, !l O Company Name Registration Number 7, 0) v Address q Expiration Date P ay Telephone 04CR 70169 SECTION 10- 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...... ❑ 11. - Home Owner Exemption The current exemption for "homeowners" was extended to include Owner - occupied Dwellings of one (1) or two(2) families and to allow such homeowner to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. CMR 780, Sixth Edition Section 108.3.5.1. Definition of Homeowner Person (s) who own 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 homeowner Such "homeowner" shall submit to the Building Official, on a form acceptable to the Building Official that he /she shall be responsible for all such work performed under the buildine permit. As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, you may be liable for person(s) you hire to perform work for you under this permit. The undersigned "homeowner" certifies and assumes responsibility for compliance with the State Building Code, City of Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [p Siding [O] Other [a Brief Descrip 'on of Proposed p Work: - d e D p '�Jl' �'7 L- /) VWS Alteration of existing bedroom Yes ✓ No Adding new bedroom Yes ✓ No / Attached Narrative Renovating unfinished basement Yes y No Plans Attached Roll - Sheet sa. If New house and or addition to existing housing, complete the following: a. Use of building: One Family Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No. 1. Septic Tank City Sewer Private well City water Supply SECTION 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, S U Z.AV\y%Z S ' e _ as Owner of the subject property ' hereby authorize dv .% , • 1�A5tcAA to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date I, ib W . as Owner /Authorized Agent hereby declare that the stat ements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. 7 under the pains and penalties of perjury. 0A t d w NAS I1Ct- C� Print Name / l �:� Z&&z L 8 !/ Signature 6f Owner /Agent Date NNW Section 4. ZONING Alt Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg. Square Footage % Open Space Footage % (Lot area minus bldg & paved p arkin g) # of Parking Spaces Fill: volume & Location A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO ® DONT KNOW (D YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO ® DON'T KNOW ® YES IF YES: enter Book Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO ® DON'T KNOW 14) YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained ® Obtained ® , Date Issued: C. Do any signs exist on the property? YES ® NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES ® NO IF YES, describe size, type and location: E. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common plan that will disturb over 1 acre? YES ® NO 0 IF YES, then a Northampton Storm Water Management Permit from the DPW is required. i�Y� \. �5.,.. Department use only City of Northampton Status of Permit: RECEIVED B ilding Department Curb Cut/Driveway Permit 212 Main Street Sewer /Septic Availability Room 100 WaterNVell Availability No hampton, MA 01060 Two Sets of Structural Plans nEPr.aF� 13 587 -1240 Fax 413 - 587 -1272 Plot/Site Plans rvom oN wa01 Other Specify APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION 1.1 Property Address This section to be completed by office H O l -Ab _ ], , , 4 t i ` ? Map Lot Unit VAN � o t b 6 Z Zone Overlay District 1 � Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record Name (Print) Current Mailing Address: 4r i� 5 s y - my Telephone Signature 2.2 Authorized Agent: dV1A►t� �,J PI�QS�� �,(�6 VYIAt/r nt) Current Mailing Address: 4« -16 -9 Signature Telep one SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only com leted by ermit applicant 1. Building (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 3 S 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) g 534 Check Number This Section For Official Use Onl Date Building Permit Number: Issued: Signature: Building Commissioner /Inspector of Buildings Date 409 ROCKY HILL RD BP-2012-0230 GIS #: COMMONWEALTH OF MASSACHUSETTS Ma :Bloc 44 - 010 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: Windows replaced BUILDING PERMIT Permit # BP- 2012 -0230 Proiect # JS- 2012- 000357 Est. Cost: $18534.60 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: R H & SONS CONSTRUCTION 136407 Lot Size(sq. ft.): 85377.60 Owner: SCHUSTER NICK A & MARY & SUZANNE SCHUSTER Zoning: SR(100) Applicant: R H & SONS CONSTRUCTION AT: 409 ROCKY HILL RD Applicant Address: Phone: Insurance: P O BOX 596 (413) 642 -3436 WC WESTFIELDMA01085 ISSUED ON: 919120110:00:00 TO PERFORM THE FOLLOWING WORK.- Replace 17 windows 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: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace /Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: FeeType: Date Paid: Amount: Building 9/9/20110:00:00 $35.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner