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24A-143 (2) 33 ROE AVE BP-2016-1360 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 24A- 143 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ADDITION BUILDING PERMIT Permit# BP-2016-1360 Project 4 JS-2016-002338 Est. Cost: $218600.00 Fee: $1421.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: THOMAS DADMUN 107919 Lot Size(sq. ft.): 7710.12 Owner: O'REILLY JOHN&PATRICIA ANN R Zoning. URA(100) Applicant: THOMAS DADMUN AT. 33 ROE AVE Applicant Address: Phone: Insurance: 60 SCHOOL ST (413) 387-7381 HATFIELDMA01038 ISSUED ON:5/23/2016 0:00:00 TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 1 STORY ADDITION(FAMILY RM,KITCHEN,DIN ING,SCREEN PORCH & DECK,WINDOWS, SIDING & ROOF 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 5/23/2016 0:00:00 $1421.00 212 Main Street, Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2016-1360 APPLICANT/CONTACT PERSON THOMAS DADMUN (ra ADDRESS/PHONE 60 SCHOOL ST HATFIELD01038(413)387-7381 n PROPERTY LOCATION 33 ROE AVE MAP 24A PARCEL 143 001 ZONE URA000) THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid $779 7 Building Permit Filled out s r• Fee Paid Typeof Construction:_CONSTRUCT 1 STORY ADDITION(FAMILY RM,KITCHEN,DINING,SCREEN PORCH &DECK,WINDOWS, SIDING&ROOF New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 107919 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: Approved Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Permit With Site Plan Major Project: Site Plan AND/OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance* Received&Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission Permit DPW Storm Water Management litio J O� —/5 Signature of Building OM ial Date Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health,Conservation Commission,Department of public works and other applicable permit granting authorities. * Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of Planning&Development for more information. ty of Northampton j E EwE� ilding Department 212 Main Street 7 20,6 Room 100 No fhampton, MA 01060 13- 87-1240 Fax 413-587-1272 APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: i SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: �6IiL3 0`f4tLLI 9 33 �Pk, A�—, ObgAiwAprripf OA o Coikt Name(Print) Current Mailing A gress: —�— d` Signature Telephone 2.2 Authorized Agent: Name(Print) Current Mailing Address: X" �' GGV� 413- w? t Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 6 00 (a)Building Permit Fee 2. Electricali o j (b)Estimated Total Cost of 11'4uo) Construction from 6 3. Plumbing ,10o a Budding Permit Fee 4. Mechanical (HVAC) 0 v 5. Fire Protection 6. Total=0 +2+3+4 +5) V Q oo, `�10 Check Number This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date g+....+mtir�.r�r..aar�r.....��Yr t �.. y�7� � � ig 4:k a' �w t 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 ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,„_, ,C,,,,,,,,,,,,,,,_,,,,,,,,,,,,,,,,.......... ,,,,,,,,,,,,,_,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, LotSize I........................1-11- ,,,,,,,,,,,,,.,,......... ...........,..w........... r ..,,,,.,,,,,,,.,.,,,,_,,,_,,,,,..,,,,_,,,,,,_...,..,,. .....,.,,,,..,.,.......,.....,.....................................,,.,., „_,,,,,,,,,,,,,,,,_,,,,,,,,,,,,,.................._............,_ ..........................,_„_ Frontage V. Setbacks Front ....................r.., �,�.�,,.,,,,..,_ Side U= R:= L:_�11 . „ R:,,,,,�, .. ...........If--...Rear Building Height Bldg. Square Footage % Open Space Footage ,................ % (Lot area minus bldg&paved parking) i s 9 9 #of Parking Spaces ..............x 1......,,.,_r .,_ Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO ® DON'T KNOW � YES IF YES, date issued:` IF YES: Was the permit recorded at the Registry of Deeds? NO ® DON'T KNOW ® YES 0 ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, „,,,,,,,,,,, .,,,,,,H,m.,,,.,,,..,,,,� 6,,,,,,,,,,,,,,,,,,,,,,..,,,,,,,,,,,,,,,.,,.,,,,,,,,,,,,,,,,.,.,,,..M,,,,., IF YES: enter Book Page and/or Document# �...............�.,._��.� .��,._.�.,,w H.��mm.......__..a .._.............�,,_.,,....__._........._.__..........__.....; B. Does the site contain a brook, body of water or wetlands? NO ® DON'T KNOW © YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained © Obtained ® , Date Issued: 6 C. Do any signs exist on the property? YES 0 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 krj- I.,,.,................................................ ......_,,,_........ _.........,.,.............,., ,,,,.,,,,,,.,.,...........................................................,....,.................................,.,,,,,,,,_,,,,,, IF YES, describe size, type and location: r 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 Ah IF YES, then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) 7 New House ❑ Addition Replacement Windows Alteration(s) ❑ Roofing Or Doors D Accessory Bldg. ❑ Demolition ® New Signs [0] Decks [[n Siding [IQ] Other[p] Brief Description of Prop ed Work: 00- zy(UI✓`� gy lnto7 10CL, fAA1L 1 �w1 i Diag 5(*40 PP,"w� � � I�E,IJ W IOVCW!:', 5 ip)a ' r 'r Pooh►%, Alteration of existing bedroom Yes X No Adding new bedroom Yes N No Attached Narrative Renovating unfinished basement Yes C No Plans Attached Roll -Sheet a. Use of building : One Family I Two Family Other b. Number of rooms in each family unit: Number of Bathrooms .� c. Is there a garage attached? i 16 (p SGtrii V EC� i) d. Proposed Square footage of new construction. ��' �7Q � tt�1F��Dimensions f1o1.jvu-Ski- e. Number of stories? f. Method of heating? �Y(5110 b f4ki A10 Sfr-I I' Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? In. Type of construction u�0 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 . I. Septic Tank City Sewer X Private well City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, (1x)t) as Owner of the subject property hereby authorize Vk1)1AUtJ 0 �,4714vx3 45(60 1 SrY{UGl1er� to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date I' 1 -kk , � as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Print Name 4 j" MAI 1 '1�l Signature of Owner/Agent Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: NotApplicable ❑ IIp Name of License Holder: License Number 912 1 a,9D Add r s Expiration Date Signature Telephone Not Applicable ❑ Company Name Registration Number bo S6L Sr., 4 -tbu f MA ar,03� Imo« Address C� r Expiration Date Telephone 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...... ❑ 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-vear 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 building 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 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations I Congress Street, Suite 100 Boston, MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): -Ver�M.vyj D"(&-a; Address: (9b 5&koc, City/State/Zip: 1&11 -'Lo t4 bwbPhone #: Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. ❑ New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition workingfor me in an capacity. employees and have workers' Y P Y 9. F7 Building addition [No workers' comp. insurance comp. insurance. required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] + c. 152, §1(4),and we have no employees. [No workers' 13.0 Other 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: Policy#or Self-ins. Lic. #: Expiration Date: Job Site Address: ��J Pt, Aqb City/State/Zip: 0bCcRb TV, 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 Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify n er the pains a d penalties of perjury that the information provided above is true and correct. Signature: Date: Phone Official use only. Do not write in this area, to be completed by city or town official. 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#: City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111 , S 150A. Address of the work: 33 V ok Aqr . The debris will be transported by: /LU 114, FtL1(,G1 C% The debris will be received by: Building permit number: Name of Permit Applicant Date Signature of Permit Applicant Rick/ORilly Project, 33 Roe Ave., Northampton, MA Sole Proprietor Does Sub have Insured Sub-Contractor Name Type of Work Performed employees Yes No Yes No Paul Ayotte X Carpentry X Cortina Tile X Flooring&Walls X New England Granite X Countertops X Rightway Drywall X Drywall X SMG Plumbing& Heating X Plumbing& Heat X James Elkins Electric X Electrician X All Seasons Heating X Heating X SDL Home Improvement X Insulation X Dubay Bros Roofing X Roofing X Dion &Son Flooring X Flooring X Executive Painting X Painting X A� CERTIFICATE OF LIABILITY INSURANCE �TE( 2i�i)16 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 NAME: Dale Frank Insurance Agency PHONE FAX 413 665-8324 A/ No: (913) 665-1280 2 Amherst Road ADDRESS: wendy@dalefrankinsurance.com P.O. Box 455 INSURER(S) AFFORDING COVERAGE NAIC# Sunderland, MA 01375 INSURERA:Connecticut Underwriters INSURED INSURER B: Paul Ayotte INSURER C: 92 Laurel Park INSURER D PO Box 1063 INSURER E: ' Northampton, MA 01061-0331 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 AWL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POUCY NUMBER MMIDDIY MM/DD/YYYY LIMITS A GENERAL LIABILITY NN432953 2/8/16 2/8/17 EACH OCCURRENCE $ 500,000 X COMMERCIAL GENERAL LIABILITY PR MISES ISE ( a ocou Dnce) $ 100,000 CLAIMS-MADE E:11 OCCUR MED EXP(Arty one person) $ 5,000 PERSONAL&ADV INJURY $ 500,000 GENERAL AGGREGATE $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOPAGG $ 500,000 POLICY PRO-JECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNEDPROPERTY DAMAGE $ HIREDAUTOS AUTOS Per accident $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A j (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ i j DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULDANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Tom Dadmun ACCORDANCE WITH THE POLICY PROVISIONS. 60 School Street Hatfield, MA 01038 AUTHORIZED REPRESENTATIVE Wendy Leahy ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: Client#:41601 CORT11 DATE(MMIDDIYYYY) ACORDTM CERTIFICATE OF LIABILITY INSURANCE 3/24/2016 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 NAME: Dinah Jacobsen People's United Ins.Agency MA PHONE 413 781-6871 A/C No Ext: A/C,No): 1391 Main Street,3rd Floor E-MAIL eo ADDRESS: ma ry•hoth/,�@p les.com P PO Box 4950 INSURER(S)AFFORDING COVERAGE NAIC# Springfield,MA 01101 INSURER A:Merchants Preferred Ins.Co. INSURED INSURER B: Cortina Tile of West Springfield INSURER C 1645 Riverdale ST INSURER D: W.Springfield, MA 01089 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 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP IYLIMITS LTR INSR WVD POLICY NUMBER MM/DDYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY BOP1071849 3/30/2016 0313012017 EACH OCCURRENCE $1,000,000 CLAIMS-MADE �I OCCUR PREMISES Ea occurs nce _$500,000 Blanket Al Per Prior MED EXP(Any one person) $5,000 Written Contract Y PERSONAL&ADV INJURY $ GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRO- POLICY X ECT F7 LOC PRODUCTS-COMP/OPAGG $2,000,000 OTHER. $ 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 Peraccident $ A X UMBRELLA LIAB X OCCUR CUPS146566 3/30/2016 03/30/201 EACH OCCURRENCE $1,0005000 EXCESS LIAB CLAIMS-MADE AGGREGATE $1,0005000 DED I X RETENTION$10,000 $ A WORKERS COMPENSATION WCA1033448 3/30/2016 03/30/201 X PER OTH- AND EMPLOYERS'LIABILITYSTATUTE Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $500,000 OFFICER/MEMBER EXCLUDED? � N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Blanket Additional Insured per Merchants form MU8277(1111); Blanket Additional Insured-Completed Operations per Merchants form MU8530(1111) Proof of Insurance CERTIFICATE HOLDER CANCELLATION DADMUN Design+Construction SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Tom Dadmun ACCORDANCE WITH THE POLICY PROVISIONS. 60 School Street Hatfield,MA 01038 AUTHORIZED REPRESENTATIVE �agv�$ cJ �GI�rJ/tQitcc ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) 1 of 1 The ACORD name and logo are registered marks of ACORD #S674601/M674571 DLJ AC�® DATE(MMIDD/YYYY) AC� CERTIFICATE OF LIABILITY INSURANCE F1/20/2016 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 NAME: Lynne Methot Extension 102 Foley Insurance Group Inc. HONE Ext): (413)214-7474 FAX No: (413)214-7447 37 Elm Street E-MAIL ADDRESS: insurance rou lmethot@foiey g p'com INSURERS AFFORDING COVERAGE NAIC# West Springfield MA 01089-2703 INSURERA:Patrons Mutual Insurance Co of CT 20028 INSURED INSURERB:Travelers Indemnit Co of CT 25682 New England Granite LLC INSURER C: ATTN: Andrey Korchevskiy INSURER D: 75 West School Street INSURERE: West Springfield MA 01089 1 INSURER F: COVERAGES CERTIFICATE NUMBER CL15102608707 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. IEXP LTR TYPE OF INSURANCE ADDL SWVp UER POLICY NUMBER MMIDDYNYYY MWDDYLIMITS X I COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE � OCCUR DAMAGE TO RENTED 300,000 PREMISES Ea occurrence � $ j BOP2741752 5/23/2015 5/23/2016 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GE,,N'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 2,000,000 . X�I POLICY P JECT RO � LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ i ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident j UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X PER 70TH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000 B .OFFICER/MEMBER EXCLUDED? N I A (Mandatory in NH) IEUB2191:876715 10/22/2015 10/22/20161 E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Proprietor/Partner/Executive Officer/Member exclusion applies on Workers Compensation. CERTIFICATE HOLDER CANCELLATION tomd@dadmundc.com SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THOMAS DADMUN THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 60 SCHOOL STREET ACCORDANCE WITH THE POLICY PROVISIONS. HATFIELD, MA 01038-9747 AUTHORIZED REPRESENTATIVE Brian Foley/JOANN ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025 r?014011 DATE ACOORID0 CERTIFICATE OF LIABILITY F1/15/2016(MMIDDIYYYY) 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 Trace? Kuklewicz NAME: y A.H. Rist Insurance Agency, Inc. PHONE (413)863-4373 A N A/C No: (413)863-9658 159 Avenue A E-MAIL ADDRE S S: P.O. BOX 391 INSURERS AFFORDING COVERAGE NAIC# Turners Falls MA 01376 INSURERANational Grange Ins CO. INSURED INSURER B Rightway Drywall, Inc. INSURER C: 206 Coles Meadow Road INSURERD: INSURER E: Northampton MA 01060 INSURER F COVERAGES CERTIFICATE NUMBER:2015 CERT 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 UBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD/YYYY MM/DDIYYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE T RENTED PREMISES Ea occurrence $ 50,000 A CLAIMS-MADE FX7 OCCUR MPT17195T 10/18/2015 01/15/2016 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PRO 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 I I RETENTION$ $ WORKERS COMPENSATION WC STATU- I 1OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS I ER ANY PROPRIETOR/PARTNER/EXECUTIVE❑ E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Classification: Drywall CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Tom Dadmun ACCORDANCE WITH THE POLICY PROVISIONS. 60 School Street Hatfield, MA 01038 AUTHORIZED REPRESENTATIVE y Trace Kuklewicz/DNP ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025l9mno.,)M Thn ARr1Rr1 nmma=nrl Innn nrn rcnictnrcri mnrlrc of Arr1Rr1 A�4� CERTIFICATE OF LIABILITY INSURANCE � ;9i�o'i6Y' 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(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 andorseme s. PRODUCER CONTA NAME:CT Elizabeth Carball0 Finck & Porras Insurance Agency Inc. PHONE (413)527-5520 FAXIAIC.No:(413)527-b970 6 Campus Lane Ap RES..bcarballo@finckandperras.eom INSURERS AFFORDING COVERAGE NAIC# Easthampton MA 01027 INSURER Arbella Insurance Group 17000 INSURED INSURERB:Arbella Protection 41.360 S M G Plumbing & Heating INSURERC: 133 Wyben Road INSURER D; INSURER E Westfield MA 01085 RJSURERF: COVERAGES CERTIFICATE NUMBER:CL1591801795 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. TR TYPE OF INSURANCE POLICY NUMBER MMI 10Y EFF POLICY EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLASMS•MADE ' til OCCUR PREMISES�Ea occurrence) $ 50,000 e500031965 9/4/2015 9/4/2016 MED O(P(An one person) $ 5,000 _ PERSONAL BADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 $. POLICY❑ PRO- LOC PRODUCTS-COMPIOP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY Ea a M'c Wden NQLE LIM17 $ ANY AUTO BODILY INJURY(Par person) $ B ALL OWNEDSCHEDULED AUTOS AUTOS 1020016724 4/2/2018 4/2/2016 BODILY INJURY(Per acddent) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per I UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER Tfl- AND EMPLOYERS'LIABILITY YIN I STATUTE ANY PROPRIETORIPARTNERIEXECUTIVE ❑ NIA E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEF $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 191,Additional Remarks Schedule,may be attached It more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Tom Dadmun / D+C THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 60 School St. ACCORDANCE WITH THE POLICY PROVISIONS. Hatfield, MA 01038 AUTHORIZED REPRESENTATIVE E Carballo/BETH '°� '� ©1988-2014 ACORD CORPORATION. All rights reserved. ACORID 25(2014101) The ACORD name and pogo are registered marks of ACORD INS025(201401) ACURE0 CERTIFICATE OF LIABILITY INSURANCE7 .DATE(MMIDDiYYYY) 5/17/16 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHT'S 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 ruts to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Bresnahan Insurance Agency, In PHONE a Edi- (413) 536-0536 FAX Nc: (413) 534-4291 100 Whiting Farms Road -Met Holyoke, MA 01040 ADDRESS: INSURE S AFFORDING COVERAGE ( NAIC# - INSURER A;Ma fre/Commerce Insurance Co. —� INSURED I NSURER 8: James Elkins INSURER C: 2 Williams Street 1 RERD: Holyoke, MA 01040 --- 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 POL CfES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE AM SUER POLICY EFF P CY EXP POUCY NUMBER M/DDIY MM/DD/ LIMITS A GENERAL LIABILITY YM0750 5/5/16 5/5/17 EACH OCCURRENCE $ j QQQ QQQ X COMMERCIAL GENERAL LIABILITY DAMAGE TORS RENTED occurrencel $ 100,QQQ -Y CLAIMSWADE 1Z OCCUR MED EXP(Any ore person) $ 51000 PERSONAL&ADV INJURY $ j QQQ QQQ GENERAL AGGREGATE $ 2,000 QQQ GENT AGGREGATE LMIT APPLIES PER PRODUCTS-COMPIOPAGG $ 2 QQQ QQQ X j POLICY PRO- LOC $ AUTOMOBILE LIABILITY ONBI ED IN L AA IT i Ea aLY INJURY --- ANYAUTO BODILY INJURY(Per person) ,$ ALL OWNED SCHEDULED i AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROP( ERiI DAtv1AGE $ - HIRED AUTOS AUTOS Per accident UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE _ $ DED RETENTION$ AGGREGATE WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN 6dtl ANY PROPR IETOR/PARTNER/E XECUTNE OFFICERIMEMBER EXCLUDED? N/A E.L.EACH ACCIDENT" $ (Mandaeory in NH) UE.L.DISEASE-EA EMPLOYEE $ es,describe under - - SCRiPTIONOFOPE RATIONS below E.L.DISEASE-POLiCYLIMIT $ 3 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Rerraft Schedule,if more space is requred) Electrician CERTIFICATE HOLDER CANCELLATION SHOULDANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Dadmun Design & Construction ACCORDANCE WITH THE POLICY PROVISIONS. 60 School St. Hatfield, MA 01039 AUTH RE ENNTATIVE C 19882010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: tomd@dadmundc.com AC�® DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE F1/14/2016 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 Barbara G nkiewicz NAME: ry Webber & Grinnell PHOIAIC.NENo Ext, (413)586-0111 FAX No: (413)586-6481 8 North King Street ADDRESS:bgrynkiewicz@webberandgrinnell.com INSURERS AFFORDING COVERAGE NAIC# Northampton MA 01060 INSURERA:Patrons Mutual Ins. Co. of CT INSURED INSURER B:State Auto Property & Casualty Ins. A. Dion & Son Floor Contractors, LLC INSURER C: Attn: Donald & Daren Dion INSURER D: 74 Russell Street INSURER E: Hadley MA 01035 INSURER F: COVERAGES CERTIFICATE NUMBER:Exp 2016 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. NOTVVITHSTANDING 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. INSR7_ TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR POLICY NUMBER MM/DDIYYYY) IMMIDDIYYYYI LIMITS X COMMERCIAL GENERAL LIABILITY2,000,000 �� EACH OCCURRENCE $ A CLAIMS-MADE ul OCCUR FREM SES(Ea occuE DAMAGE TO ence) $ 300,000 BOP2806463 7/1/2015 7/1/2016 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE ! $ 4,000,000 POLICYI -- ECT C' LOC PRODUCTS-COMP/OP AGG $ 4,000,000 OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident __ ANY AUTO BODILY INJURY(Per person) $ A ALL OWNED SCHEDULED AUTOS UL AUTOS BAP2406132 7/1/2015 7/1/2016 BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE �X HIRED AUTOS B !AUTOS Per accident $ i " 19 PIP-Basic $ 8,000 X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 2,000,000 A EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED RETENTION$ ICXS2125771 7/1/2015 7/1/2016 $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/M EM BER EXCLUDED? NIA B (Mandatory in NH) WCP2227689 7/1/2015 7/1/2016 E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 I I I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) CERTIFICATE HOLDER CANCELLATION tomd@dadmundc.com SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Tom Dadmun THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 60 School Street ACCORDANCE WITH THE POLICY PROVISIONS. Hatfield, MA 01038 AUTHORIZED REPRESENTATIVE M Horan, CISR/BARBG ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401) INGRAMJ001 MMILLS QRQ DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 1/18/2016 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 NAME: Melissa L Mills The Jarrett Agency PHONE FAX 657 Enfield Street WC, /c No Ext):(860)745-4222 A/C No): (860)741-6901 Enfield,CT 06082 E-MAIL nick the•arretta enc com ADDRESS: � � g Y• INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Main Street America Assurance Company 29939 INSURED INSURER B Executive Painting and Wall Covering LLC INSURER C: 10 South Road INSURER D: Enfield,CT 06082 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. IEXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DDYIYYYY MM/DDEFF Y/YYYY LIMITS A COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 LU CLAIMS-MADE FXI OCCUR MPT7137P 08/22/2015 08/22/2016 PREMISES Ea occurrence $ 500,000 X BOP MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO 171LOC PRODUCTS-COMP/OPAGG $ 2,000,000 JECT OTHER: $ AUTOMOBILE LIABILITY COMED SINGLE LIMIT $ Ea acciBINdent ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE HIREDAUTOS AUTOS Peraccident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED 7 RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1 $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Dadmun DC THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 60 School St ACCORDANCE WITH THE POLICY PROVISIONS. Hatfield,MA 01038 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Massachusetts -Department of Public Safety Board of Building Regulations and Standards C"onoruitiun Super%i*oi License: CS-107919 THOMAS DADMIV 60 SCHOOL STRIEr A Hatfield MA 01038 � Expiration Ccxrrmissianer 1391217 i , N V Office of Consumer Affairs and Business Regulation 10 Pari Plaza - Suite 5170 Boston. Massachusetts 02116 Home Improvement Contractor Registration Registration: 179682 Type: LLC Expiration: 8/28/2016 Tr# 257334 THE TUCKER GROUP LLC. THOMAS DADMUN 60 SCHOOL ST HATFIELD, MA 01038 Ulpdate Address avid return card.Mark reason for change. Address Renewal Employment Last Card ffice of Consumer Affairs&Business Regulation.,r=fl, �-� Regulation License or registration valid for individul use only A ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: gistration: 179682 Typo: Office of Consumer Affairs and Business Regulation z ^ Exoration: 812812016 LLC 10Park Plant-Suite 317 Boston,MA 02116 THE TUCKER GROUP LLC, THOMAS DAOMUN 60 SCHOOL ST ��� _..... HATFIELD,MA 01038 Undersecretary Not valid without signature TE CERTIFICATE OF LIABILITY INSURANCE FDAT/(6/2016Y) 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 NAMECT Susan Fleury, CIC, CISR King & Cushman Inc. Ai N o E t: (413)584-5610 FAX No:(413)584-9322 P.O. Box 447 E-MAIL g ADDRESS:SFleury @Kin Cushman.com 176 King Street INSURERS AFFORDING COVERAGE NAIC# Northampton MA 01061 INSURERAMain Street America Assurance Co. 29939 INSURED INSURER S: DAD14UN DESIGN & CONSTRUCTION INSURER C: 60 SCHOOL ST INSURER D: INSURER E: HATFIELD MA 01038-9747 INSURER F: COVERAGES CERTIFICATE NUMBER:CL161601268 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. 1NTR TYPE OF INSURANCE ADL UBR POLICPOLICY NUMBER MM/DDNYYY POLICY EXP LIMITS X COMMERCIAL GENERAL LIABILITY 1 000 000 EACH OCCURRENCE $ � , A CLAIMS-MADE 1�1 OCCUR DAMAGE TO RENTED 500,000 PREMISES Ea occurrence $ MPT4694Q 11/13/2615 11/13/203-6 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY F]PRO- a LOC -2,000,000 JECT PRODUCTS $ OTHER: Identity Recovery $ AUTOMOBILE LIABILITY COMBINED SINGLELIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OT - AND EMPLOYERS'LIABILITY Y/N TAT E ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? N 1 A E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ DESCRIPTION OF OPERATIONS/LOCATIONS VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached If more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Sample THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLI VISI AAt AUTHORIZED REPRESENTATIVE L/ ©998 - ed. ACORD 25(2014109) The ACORD name and logo are registered marks of ACORD INS025(201401) 5- IA City of Northampton Building Department > LU F- Plan Review 212 Main Street LU Northampton, MA 01060 IL Af F I 1� IT � 13 11 >LU 2 Nl FI—K.-ION -M—L, KM— W 0 0 Lz{ cc 2 0 mumoom Z / l .......... ....... LL FIRST FLOOR PLAN PROPOSED FIRST FLOOR PIAN EXISTING SCALE: 1/4"= 1'-0" SCALE: 1/4"= 1'-0" IIHOII Seu SCALE:AS STATED IIL0 I oi VJI l 14 V "ANN.. kk --�: f PROPOSED EXTERIOR ��'4EXISTING EXTERIOR �7777 L-J dia,Ke�,A S a W a V" �� IY�,— �4'a,• Lu �- d o riull MEW - _ o tr7 W < f FAMILY 6-0.�� I — 4 = IL F,\\111.1"u\1 W 0 „ \\tii O • s ''b o��„rx 1NU L 1. UR 1r L0.4U. qp li�l” 1'-F `ROIA T.BO E I _i0 E BE II SRN TOP(O O — FrvFn — — D NIN' � WY 3.2 : �� COii1 � rel FN�'xr \11-llli()(1D1 � � M_LlI LII INf. � �y I � � N ✓ rreAnurvr.� DBIFNSIUNED FUNS HEFT: FIRST FLOOR PLAN- PIER LOCATIONS & FRAMING FIRST FLOOR PLAN - DIMENSIONS 2 SCALE: 1/4"= 1'-0" SCALE: 1/4"- 1'-0" SCALE:AS STATED O (7 K LLY O K O i U Q g yN Cc � � j� l t t1'!'-I 11 Iif':l\IIHI IFI)Jk t II[It-; (}. Z 11()TPI\I,!..I .. zI ! i[li\ IT,t k I f 1 1:.?:. :Ill)\'. il.l Q TAIN.\Il I)*.T.t(�i,)\IA!t'lI I' ITI\'1,. � V.I-l.Y Il'V"Al'11'1 I". 11"1 11 VI I(t\ IL I IS i N ! 17F,1Pil,U)Tltni Tel.i\T(1I FXTSTT'I;117 i\' .D IFFt;I.Ta. 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