08-021 (12) From Linda Alstede At IRM Insurance FaxlD 413-734-8525 To:Department of Building and Inspection Date 413103 0320 PM Page:1 of 1
•
ACORD. CERTIFICATE OF LIABILITY INSURANCE p�� DATE IMMAKINYTY)
JWCOT50 04/03/03
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
TRW tasurance Ayncy, Inc. ONtYAND'CONFERS NO RIGHTS UPON-THE CERTIFICATE
Barry M. Stephens, CPCU HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
75 North Main St.-P 0 Box 564 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
East Longmeadow MA UIITZS
Phone: 413-759-0010 Fax:413-759-0017 INSURERS AFFORDING COVERAGE NAIC#
Kamm INSURER A 0....D...ACOTE ITES TraIICe-
INSUPER 6.
S 1+ Cotton- INSURER C T
P.0. Box 921 INSURER.b.
Northampton MA 01061 — —
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING
• ANY REOt1IREMBMT,TERM-ORCONOffIONOe RIff CONT1ERCT OR OTHERDOCUMetT WiTI 1ftEsec T T9 WHICH-THIS CER-TIFICATE MAY eeissup 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 SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
POLICY NUMBER POLICY EFFECTIVE, POLICY EXPIRATION. LIMITS
LTR SAD TYPE OF WSURANCE DATE IMMIDDJYYI DATE IMMDD/YY)
GENERALUABIUTY EACH OCCURRENCE $ 1000000
GRMISE IORENAU�— $ 100000
14 _&_ cveMER�:uLC�r�wLllsLUClr: CBIi563134 81/01/62 D7/O1f43 PrzEmisES(E,rnr
CLAIMS M A D E X OCCUR MED EXP(Ahy one person( 5 5000
PERSONAL a OVII4ARY $ 1000000
GENERAL AGGREGATE $2000000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS COMP/OP AGG S 2000000
Z I POLICY ECT LOC
AUTOMOBILE LIABILITY
COMBINED S ROLE UM!r s 1000000
A ANYAUTO CBX 5U640C 07/02/02 I 07/02/$3 I Eaa UU
ALL OWNED AUTOS
Y FnALLTCIS
(Pe(person)
Y HIRED AUTOS BODILY INJUPY
S NON-OWNED AUTOS
(Per 3ccidenti
PROPERTY DAMAGE $
(Per accident]
GARAGE LIABILITY AUTO CUL' EA ACCIDENT $
7 ANY AUTO EA ACC $
OTHER THAN
AUTO ONLY AGG $
EXCESS/UMBRELLA UABIUTY
.A EACH OCCURRENCE $1000000
31 OCTET Li CLAMS MADE rRnw1 1031fi n 7/O}A 02 07t BL/O 3-
AGGREGATE $1000000
$
S IDEOUCTI$LE
.RETENTION $10000 $
'NC STA?LL OTH-
WORKERS COMPENSATION AND TORYLIMI TS ER
FAARLOYERi WBLLIIY
E L.EACH ACCIDENT $
ANY ROME 1ORIPARTNEPoEXEWTIME —
OFFICER/MEMBER EXCLUDED? E L.DISEASE-EA EMPLOYEE $
n yes,oeSTERe under
SPECIAL Pcrcens dre5 rRTOR €L.DISEASE-POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES 1 EXCLUSIONS ADDEO BY ENDORSEMENT I SPECIAL PROVISIONS
'Landscape Gardening, S ,et.e Fastahlation- Ex...a►dticnr, Grading of
Land/Workers Compensation to be Sent Directly by Carrier
•
CERTIFICATE HOLDER CANCELLATION �T
CI TYNHA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Northampton DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
Dept. of Bldg. and Inspection NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
Fax: 411-587-1272
212 Main Street IMPOSE-NO OBLIGATION OR LIABILITPOFART KIND UPON THE Brawn ITS AGENTS OR
Northampton MA 01060 REPRESENTATIVES
AUTHORIZED REPRESENTATIVE
IRM Insurance Agency, Inc.
ACORO25(2001108). ACORD CORPORATION 1988
. 4 .
1H&Nip CITY OF NORTHAMPTON, MASSACHUSETTS
ate`" ` �" DEPARTMENT OF PUBLIC WORKS
;`��{} _ 125 LOCUST STREET
!"�� NORTHAMPTON, MA 01060
413-587-1570
FAX 413-587-1576
George Andrikidis, P.E.
Director, (_'itv Engineer
March 28, 2003
Anthony Patillo, Building Inspector
Municipal Office Annex
212 Main Street
Northampton, Ma 01060
Dear Mr. Patillo:
The water service at 766 North King Street has been shut off at the property line and the
water meter removed from the premises as of December 3, 2002.
Please contact me if you have any questions.
Sincerely,
cillAAAlk---R01--0—i.v .,Q€41
Charles Borowski
Superintendent of Water
CB/lvc
Cc: George Andrikidis, Director of Public Works
Ned Huntely, Assistant City Engineer
MAR 31 2003 1 : 03 PM FR TO 92470276 P . 01/01
Massachusetts Electric
A National Grid rid Company
March 31,2003
Jeremy Cotton
P.Q.Box 0921
Northampton,MA 01061-0921
Dear Mr. Cotton:
This is to verify that Massachusetts Electric Company removed the electric service and meter at
766 North King Street,Meter#079219951 in Northampton,Massachusetts effective March 31,
2003 for building demolition.
Sincerely,
Peter J.Normandin
Supervisor
Operations Overhead Lines
PJN/j1
PO BOx 507
Northampton,MA 01061-0507
413.582.7200
** TOTAL PAGE . 01 **