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24D-173 (6)
206 STATE ST BP-2017-0799 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:24D- 173 CITY OF NORTHAMPTON Lot:-000 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:renovation BUILDING PERMIT Permit# BP-2017-0799 Project# JS-2017-001328 Est.Cost:$6000.00 Fee: $100.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: use Group: GERARD STORDEUR 108497 Lot Size(sp ft): Owner: peter whalen Zoning: URC(I00)/ Applicant: GERARD STORDEUR AT: 206 STATE ST Applicant Address: Phone: Insurance: 61 NONOTUCK ST (323)363-0659 Workers Compensation FLORENCEMA01062 ISSUED ON:12/20/2016 0:00:00 TO PERFORM THE FOLLOWING WORK:CONSTRUCT 2 PARTITION WALLS TO CONVERT 1 OFFICES SPACE INTO 2 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: OI: 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 12/20/2016 0:00:00 $100.00 212 Main Street,Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner 4 Version .7 Commercial Building Permit May 15, 2000 Department use only City of Northampton Status of Permit. Building Department Curb Cut/Driveway Permit 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability Northampton, MA 01060 Two Sets of Structural Plans phone 413-587-1240 Fax 413-587-1272 PlotSite Plans Other Specify APPLICATION TO CONSTRUCT, REPAIR,RENOVATE, CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Pro a Address. This section to be completed by office z�+e S4r ee 1 Map Lot Unil Zone Overlay District YVoiSC-Ssfih,l yMe& 016‘6 - -- Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: likilaName Pririr) ffr-O 11Ff�(1yG (Print) Current Mailing Address: Signature a / / Telephone 2.2 • tr.rized A•ent ..J� j� rA/ 5+o(cjeur 6/ /✓r74_074zck ?frceT Name(Print) Currelpiling Address Signature Telephone 72-3 - 3 6 3 - O 6 C? SECTION 3-ES • ATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building d O © (a)Building Permit Fee 2. Electrical /U O 0 '' (b)Estimated Total Cost of Construction from(6) 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=(1 +2+3+4+5) 6, C O Check Number _tgq,y/� 41(6r° This Section For Official Use Only Building Permit Number Date Issued Signature: ___.— r_=-5 ) Building Commissi erllnspect of BuildingsDate X21 if —P/qO/, ' • 9 ?us• � L • 4 VersionI 7 Conunercial Building Permit May 15,2000 SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations 0 Existing Wall Signs ❑ Demolition❑ Repairs Additions ❑ Accessory Building Exterior Alteration 0 Existing Ground Sign❑ New Signs❑ Roofing I] Change of Use❑ Other 0 Brief Description Enter a brief description here 04J /at is7 .2 /"tet/'�%?Lies�1 W Its 7" Con G' Of Proposed Work:. / a CEY/+p C /� / ...S ire a2/1"0 s2 dct� ce SECTION 5-USE GROUP AND CONSTRUC ION TYPE USE GROUP(Check as applicable) I CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A � ❑ A-4 0 A-5 ❑ 18 ❑ B Business C1�( 2A ❑ E Educational ❑ 28 ❑ F Factory 0 F-1 0 F-2 0 20 0 H High Hazard 0 3A 0 1 Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R Residential 0 R-1 0 R-2 ❑ R-3 0 5A ❑ s Storage 0 S-1 0 S-2 0 58 ❑ U Utility ❑ Specify:. M Mixed Use ❑ Specify .. _. _.. S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE Existing Use Group: _. Proposed Use Group Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34) SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor(sf) 1s 2m 2"° 3rd _... 3rd ... ..... 4m 4 ' _. ..... Total Area(sf) Total Proposed New Construction(sf) Total Height(ft) _. _. _ _._..... Total Height ft _ 1 7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone]] Municipal ❑ On site disposal system]] Versionl.7 Commercial Building Permit May IS, 2000 S. NORTHAMPTON ZONING Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front Side L: R . _ . L 2 .. Rear ..... Building Height -- - Bldg. Square Footage ^/ — --- Open Space Footage (Lot area minus bldg&paved parking) #of Parking Spaces _i. Fill: _... (volume&Location) A. Has a Special Permit/Variance/Finding ver been issued for/on the site? NO 0 DONT KNOW YES o IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW Q YES Q IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained Q , Date sued: 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 0 NO IF YES, describe size, type and location: E Will the construction activity disturb(clearing,grading,exca ion,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES Q NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. • Version,7 Commercial Building Permit May 15,2000 SECTION 9)PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES•FOR BUILDINGS AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116(CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED SPACE) 9.1 Registered Architect: Nat Applicable D Name(Registrant)., .. .. _.. Registration Number Address Expiration Dale Signature Telephone 9.2 Registered Professional Engineer(s): Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Respons bdity Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name ... _ .. _.. . Area of Responsblity.. ... Address Registration Number Signature Telephone Expiration Date 9.3 General Contractor �` 1 ra 4 _5. rletA( Fs' I'S S hi"L .... Not Applicable D Comprye Name r C�wJ Rode cAT_ Res onsible In Charge of Constructon � l �G0•te/uck I/cc F I (orencc (fricc oT Q6"— Address Ajr‘z____. 723 36.3--0 e15 7 ignature Telephone Versfonl.7 Commercial Building Permit May 15,2000 SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) �-�(/ Independent Structural Engineering Structural Peer Review Required Yes 0 No �/J SECTION 11 -OWNER AUTHORIZATION•TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMITy I, Il \ 4 ` o "rr rlaf/Ji efrimi IRdwLit,as Owner of the subject property hereby authorize 9 erArd.. Sfcrci e(.1 . .. _. . _. to act on my behalf, in all matters rela 0 //zf. p this building permit application 7/// Signature of Owner �iU( _ �/j'i Date .... //y--) }r I Date I• �z err^c� S brd e ur ,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 sunder the pairs and penalties of penury era(J. c"faa61 eu.r _... _ Print Nam= Signature of ownerIAgent Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ElName of License Holder 6—er01/47-1 S1a CIet,1/4r License Number 67 f l i' CS--108 LI 9 7 / vG20 uc C S" �P Address Expiration Date orr e ✓✓lam 01 ° S -4— �}j� I2 — ( 3 - 2oi � Signature %/ �J2 3 T e3 o —SGS( SECTION 13. KERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152,§25C(6)) Workers Compensation Insurance affidav ust be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the bui ng permit. Signed Affidavit Attached Yes No 0 The Commonwealth of Massachusetts t s — Department of Industrial Accidents Office of Investigations ver_ -r 600 Washington Street Boston,MA 02111 emvw.mass.gov/dia Workers' Compensation Insurance Affidavit. Buildens/ContractorslElectricians/Plumbers Applicant Information .- Please Print Legibly Name (6nsfness/organizatiodlnd idual): t/ er r 3/ (�eCk(' Address: 6/ /Ice"- _..... ._ City/State/Zip: ......_ DfCn Ce c00 a-Phone k: 3Z - 3 SJ - O 6/ S Areyou you an employer?Chet the appropriate box:t! Type of project(required): I.�rJI am a employer with 4. ❑ I am a general contractor and Z employees(full and/or part-timed? have hired the sub-contracts 6. New construction 2.❑ I am a sole proprietor or part er- listed on the attached sheet. 7. _ Remodeling ship and have no employees These sub-contractors have g. ❑ Demolition working for me in any capacity. employees and have workers' comp. insurance.] S. .Bui ing addition [No s' comp.insurance required.] ] 5. 0 We are a corporation and itt 10.0 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. 72 ❑ Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.0 Other_ comp. insurance.required.] L__ 'Any applicant that checks bay PI must also fill out the section below showing their workers'compensation policy information. Homeownent who submit this affidavit indicating[boyars dein$alt work and then hire outside convectors rmist submit a new affidavit indicating such. +Contactors that check this bone must attached an additional sheet showing the nanx of the subcontractors and state whether ornot arose twines leave 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 polity and job site L formation. �/j �/J Cosurance Company Name: �flfi7 f/(GL ytJ, C. (� Policy#or Self-ins.Lie. iis/7We -1Ob26[3"y(7/20.2 /1t Expiration Date: 6 �� "�y/�` Job Site Address: S/a fr ' 'cc 1 City/State/Zipnb/7*t%ti ,alk 04 is 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 a;. 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 DLA for insuyyurance coverage verification. I do herebacme: eerH�=er the pal arz T£(ti7eso that the information provided J iPp// J D ti f P l jury f /2. e and correct. Si acme: - Date: Phone N: / 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): • I.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: 204 S Irl lT- 67- • The debris will be transported by: J?Rit t 572ROLuk. The debris will be received by: ktcbAi enk ��% (UIJ? 51`5 5 Building permit number: Name of Permit Applicant Date Signature of Permit Applicant Gerard Stordeur Finishing 61 Nonotuck Street Florence, MA 01062 323 363 0659 Commissioner Hasbrouck /2—/g —illoissoir7, 2016 Subject: Request for Waiver I request that you grant a modification to waive the requirement for control construction for the construction of 2 partition walls in one large office space in order to convert it into two smaller office spaces at 206 State Street in Northampton because the work is of a minor nature,will not affect health, accessibility, life and fire safety,or structural requirements and is impractical in that the cost of control construction is considerable when compared to the cost of the proposed work. All work will be completed within the prescriptive requirements of 780 CMR.Thank you for your consideration. "Mass Amendments,sections 107.1 allows for an exclusion from control construction for this project" Respectf. JerryStorde r Gerard Stordeur Finishing 61 Nonotuck Street Florence, MA 01062 323 363 0659 Ir-,, Wiojow C. S` h.,Ni c ., o G Neu 006f � New � k ) ) I. 76 ` t t, _ t ! d 3 i O 6 t .7C121-icrwnA c1crsknj Gn +ince —_ re EM 151-11"4 EKW u)o4A.S. - gi.<.^»� O O II e.0.1-wLose it-+S: to u-M.l, cel'-S 4.3E-604 va�clrsu_ O 1 A y .4E.. cxrsr.w+y %o9 [_ � - PLI --l_ ` I� etas Ti-Pe. VO 1I" CC /� {{ .ate ci`I i'% 1'\ G.r,INa4 t ® /yrz.v ET _.,y- ill' U IE-R - WA 7, It '-- ey i /2 5-17 Q91 . E UP • a li 1 ' o l04r• _ vc.- —A ' I n - aY ' ea-it-Per zwew., tura. In 1 I I J 1 ars c5 rt c: Prof 3i rra.,w rine,] I t II insakos v am r=5 A5 - -�J0 i < Tom_ -_- `u/4'r4 T'tiK ' "e �Ej ;24` �I t �I PEow.r.+y-t`Cv survey _ iftr4cgouz r+.o/r,c 3`a fL 4" W/2v 2. coast- 13..lysrcAtSa 5-14-;- J _-: M`V .r-fP lcdL a Pu-.-n- M-rniir> __pi FL,S p Loofa b re ®`-Cr /VhetIrrt 2-06 51-44e 5'ree ( L471 d— 41 I 0b ac uo O� CERTIFICATE OF LIABILITY INSURANCE DAME WMODreirr 12/14/2016 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 NAME' Valerie Cantle[ WHALEN INSURANCE AGENCY PHONE No Est (413)586-1000 ... i FAX E'MAILADDRESS; valeria haleninsurance.ccm 71 KING ST. INSURER(s)ARFoRDING COVERAGE NAICY NORTHAMPTON MA 01060INSURER A: AIM MUTUAL INS CO 3375.8_ INSURED _. _ INSURERS: GERARD STORDEUR INSURER C: GERARD STORDEUR FINISHING INSURER O: 61 NONOTUCK STREET INSURER E: FLORENCE MA 01062 INSURERF: COVERAGES CERTIFICATE NUMBER: 111047 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, INSIS -MDR SUMS EXP LIR TYPE OF INSURANCE 30 WVD POLICY NUMBER IMMOOY(YYYYI I IMMODYI(YTO LIMITS .� COIWERCA.GENERALLKRR}tt EACH OCCURRENCE rGG DAMAGE TO RP I <GAiMS-MADE I OCCUR PREMISES IER. U! ne. . 11 MED EXP( y PMperson) • N/A PERSONAL a ADV INJURY GERI.AGGREGATE LIMIT APPLIES PER I GENERAL AGGRRGATE _ POLICY; (JECT ..__'LOC 'PRODUCTS-COMgOPAS OTHER. AUTOMOBILEUA9am COMBINEDDSINaLE LIMIT lEa amaq I ANY AUTO BODILY INJURY{Par person) ALL OWNED SCHEDULED • AUTOS AUTOS NIA Boouv wdueY leer accident) _ _ NED t PRinRTY OAMANP HIRED AUTOS AUTOS ATOS {{Per a^atleMl......... UMSRELLA LIAB OCCUR ' EACH OCCURRENCE _'S EXCESS LIAB I CLAIMS-MADE N/A • AGGREGATE S URN - RETENTIONS I S WrampSCOMPEaisATION X ;URGE 1... ET ANOEMPLOYERS'LhSIUTY — m OPRiSTOWPARTNEESECUTIVE YIn EL EACH ACCIDENT I S 100.000 A pine.myEn NHREXCLUDED? CIA NA MAI AWC40070346712016A 08/19/2016 08/19/2017 — yes E L DISEASE FA EMPLOYEES 100,000 DESCRIPTIQ p OPERATIONS below E L.DISEASE•POLICY LIMIT S 500,000 • N/A OESCRIPI1ON OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule.may be attached If mon space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 8,no authorization is given to pay claims for benefits to employees in stales other than Massachusetts if the insured hires.or hos hired those employees outside of Massachusetts- Tee certificate of insurance shows the nary ill force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of coverage can be monitored daily by acoeu*rlg the Proof ofCoverage-Coverage Verification Search tool at www.mass.gov/IwdMorkers-compensationlinvestigations/. Sole proprietor has not elected coverage. 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, 210 Main Street AU Iarne2EC REPRESENTATNE • Northampton MA 01060 Daniel M.Crowley,CPCU,Vice President-Residual Market-WCRIBMA W1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD GERASTO-01 VCARRIER 4CC)i2o CERTIFICATE OF LIABILITY INSURANCE °"12/14( 016 +vlanols 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 suchryendorsement(s). PRODUCER MAp MEgCT Valerie Carrier Whalen Insurance Agency PHONE - - - -- FAX N King Street we NN EMI:(413)586-1000 104 INC Nol(413)585-0401 Northampton,MA 111060AE WILREss:val¢rie@Whalenlnsurance.tdm INSURER(SI AFFORDING COVERAGE NAIL, _.. INSURER A:Utica First Insurance Company 15326 INSURED INSURER B: Gerard Stordeur DBA Gerard Stordeur Finishing INSURER C; - - 61 Nonotuck Road INSURER ; Florence, Florence,MA 01062 - - - INSURERE: 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. _ II ISR PIPE OF INSURANCE A°OL SURR POLICY NUMBER POLICY EFF POLICY EXP LIMITS MD MD IMM/DDPITYYI IMMID0.TVW1 A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1'000'000 ' CLAIMS-MADE X OCCUR ART-5056866-02 07/30/2016 07/30/2017DAMAGE TO RENTED 50,000 PREMISES(Ea occurrence) - .__. MED EXP(Any one person) 5 _ -- 5,000 -_ PERSONAL&AOV INJURY _5 1,000,000 . GEN.AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE E 2.000,000 X POLICY' 78, LOC PRODUCTS-COMPIOP AGG 'E - 2'000,000 OTHER. - - AUTOMOBILEUABIIItt I(EOM ItlEO SINGLE LIMIT E `- 1 - ANY AUTO BODILY INJURY(Per person)-OWNED SCHEDULED • a— -- AUTOS ONLY AUTOSUTBODILY INJURY(Per 0¢IOenR E MS AVTOSDNLY • PROPERTY DAMAGE -S - A( • UMBRELLA LIAS OCCUR EACH OCCURRENCE• 8 EXCESS LIAR CLAIMS-MADE_ AGGREGATE E DED RETENTIONS AND EMPLOYERS'COMPENSATION VIN STATUTE _ _PER EERH , PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT E AOFFICERME BER EXCLUDED? NIA LMaMetayIn NH) 'E L DISEASE-EA EMPLOYEE S 1 aeernoe under DISEASE: EA E L DISEASE-POLICY LIMIT I S DESCRIPTOR OF OPERATIONS I LOCATORS I VEHICLES(ACORD 101,Addmonal Ren,Ms Schedule,may be attached IImore space la required) Certificate issued as evidence of coverage. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of orihamplOn THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10 CMfin N Street ACCORDANCE WITH THE POLICY PROVISIONS. Northampton,MA 01060 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD