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32A-083 (7) 46 GRAVES AVE BP-2017-1262 GIS rt: COMMONWEALTH OF MASSACHUSETTS Map:Block:32A-083 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: FIRE DAMAGE BUILDING PERMIT Permit# BP-2017-1262 Project# JS-2017-002109 Est. Cost: $1000000 Fee: 5100.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group A R S SERVICES 094878 Lot Size(sq.ft.): 4356.00 Owner: DAUAIHY CHRISTA Zoning: URC(100)I Applicant: ARS SERVICES AT: 46 GRAVES AVE Applicant Address: Phone: Insurance: 38 CRAFTS AVE (413)272-0101 N EWTON MA02456 ISSUED ON:5/4/2017 0:00:00 TO PERFORM THE FOLLOWING WORK REMOVE WET WALLS & INSTALATION FROM AFFECTED ROOMS IN 1ST & 2ND FLOOR - REMOVE DEBRIS & STUDS ON 3RD FLOOR 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 tt 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 5/4/2017 0:00:00 SI00.00 212 Main Street, Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner - Versionl.7 Commercial Building Permit May 15,2000 ------ \ Deparfrnent use only Ls\( C.�ty of Northampton Status of Permit: `t, V 3(2-s\. Building Department Curb Cut/Driveway Permit \ = 212 Main Street Sewer/Septic Availability _ Room 100 WaterNJell Availability c Northampton, MA 01060 Two Sets of Structural Plans phone 413-587-1240 Fax 413-587-1272 PlotfSite 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 1A Property Ad This This section to be completed by office Pr r- s 71// CAA✓Es ✓iti/e- Map �f Lot "5 Unit ` -1[Vo/2.-r Mp+ �GZone Overlay District '---/---- Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: 0 UQ'I i ‘vo Name(Print) Current Mailing Address'. _T Signature Telephone 2.2 Authorized Agent: D DAJAJA Bbb S _S____-- !7O 14!.ip% Moles_R_E Name(Print) Current Mailing Addres/s�: Signature !, L Telephone T SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. BuildingOf, " 1 (a) Building Permit Fee 2. Electrical (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) i fifito c,o . Check Number int C. 10a This Section For Official Use Only Building Permit Number Date /fffy Issued Signature: // � �j�i� 5-3-/7 Buil. g Commissioner/Inspector of Buildings Date Version 1.7 Commercial Building Permit May 15.2000 SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations ❑ Existing Wall Signs 0 Demolitiondr Repairs 0 Additions 0 Accessory Building 0 Exterior Alteration 0 Existing Ground Sign 0 New Signs❑ Roofing❑ Change of Use❑ Other 0 Brief Description Enter a brief description here. RtMCJQ (/,)&f i�lfs $ if -f,n-, {i-tern 4 01ti Of Proposed Work: /Zco11S. "t) 49 /4't f .2 t �, " /COfnuu`E, Un S ,t - r DF uJSL cts SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly A-1 0 A-2 0 A-3 0 1A ❑ A-4 0 A-5 0 1B 0 B Business 0 2A ❑ E Educational 0 26 ❑ F Factory 0 F-1 ❑ F-2 0 2C ❑ H High Hazard ❑ 3A ❑ I Institutional 0 I-1 0 1-2 ❑ 1-3 0 3B 0 M Mercantile ❑ 4 0 R Residential 0 R-1 0 R-2 0 R-3 0 5A 0 S Storage 0 5-1 0 5-2 0 5B 1 0 U Utility ❑ Specify: -- ---- M Mixed Use ❑ Specify: 5 Special Use ❑ Speciry'. 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(sr) 1" 3b 4"' Total Area (sf) - Total Proposed New Construction fsf _ Total Height(ft) Total Height ft 7.Water Supply(M.G.L.c.40,§54) 7.1 FloodZone Information: 7.3 Sewage Disposal System: Public 0 Private 0 Zone'. ' Outside Flood Zone Municipal 0 On site disposal system❑ Versionl.7 Commercial Building Permit May 15,2000 8. NORTHAMPTON ZONING Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size _—_ - • Frontage Setbacks Front - - ---:. - Side L - R: Rear _ Building Height - --_- - -'- - "- -' Bldg. Square Footage - --- --__--- % ---- - Open Space Footage (Lot area minus bldg&paved -. parking) #of Parking Spaces ----- - Fill: • • (volume&IBcationl • A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO © DONT KNOW tom' YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DON'T KNOW 6,2. YES IF YES: enter Book Page and/or Document # B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW ® YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained © , Date Issued: C. Do any signs exist on the property? YES O NO O IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES © NO O 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 IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Versionl.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: Not Applicable Name(Registrant): - -- _� Registration Number Address Expiration Date Signature Telephone 9.2 Registered Professional Engineer(s)- Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Reglsiraton Number Signature Telephone Expiration Date Name Area of Resporeibiliky Address Registration Number Signature Telephone Expiration Date 9.3 General Contractor .__.� . . QY✓r Z''C S___. _. _—--- _.__ ...___... Not Applicable ❑ Company Name'. ,,,g %A- ialtu Responsible In Charge of Construction _ a ...___— q70 511A7 ' .1 J l;! Address ....::....... , ,�/ yt3 . 7.1:5))01 Signature i Telephone Versionl.7 Commercial Building Permit May 15, 2000 SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes O No 0 SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner of the subject property hereby authorize 445 Seko c s S to act on my behalf, in all matters relative to work authorized by this building permit application. l __ - _—____-_'___ _. Signature of Owner Date I, . °iwN _ .Pb-vi/t) 5 J , 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 a er pains and penalties of parlay. PrintN p� bM,LI* I4 ?bbl ,JS 91r2 / 17 _- Signature of Owner/Agent Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: 1�� Not Applicable ❑ Name of License Holder D/)/+_ _ /1'L b4j_„__ S ,C55— 0 ?-4/ C ia7,_ License Number macue gin a1h Ril E ) _ekz4_ __ ___ i !e_- ac/ 8' Address /�' Expiration Date Signa ure Telephone SECTION 13-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 Ciir No 0 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 bye /MGL c 111 , S 150A. Address of the work: y6 Ql4v /`K% S �$ F- i '114 The debris will be transported by: 414-02S 4- 1 /2_xtti.. -i The debris will be received by: C� Building permit number: —AO Name of Permit Applicant _L_E9h\A-‘/A/ I dLi//7 /(k%1 1A114! 4_/ Date Signature of Permit Applicant The Commonwealth of Massachusetts _ Department of Industrial Accidents 18--: ;1�a Office of Investigations -atria- 1 Congress Street,Suite 100 ' I- Boston,MA 02114-2017 lg �.� www.mass.gov/dia 'Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information //ff/"� Please Print Lesibly Name(Businessss/pOrggaanizatio�n/Individual): 1%/e4S `. /w 2C ' S Address: "Cf3 b( 5 l�/0 �AYl� j 40�' -'7 City/State/Zip: 0t'7��{�,J 4 V/ _m'�^7c1 "`Q/ 6 Are you an employer? Check the appropriate box: Type of project(required): I. J am a employer with [5 & 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. ❑ Remodeling ship and have no employees These sub-contractors have8. .Demolidon working for me in any capacity, employees and have workers' 9. 5 Building addition [No workers' comp.insurance comp_insurance_* required.] 5. 5 We are a corporation and its 101-1 Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.5 Roof repairs insurance required.]` c. 152,§1(4),and we have no employees. [No workers' 13.5 Other comp. insurance required.] *Any applicant that checks hoc#1 must also fill out the section below shoaina their workers'compensation policy information. +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 alum showing the name of the sub contractors and state whether or not those entities have employ vs. lithe subcontractor&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. '1 Insurance Company Name: I j a /ill H �y f^�/�J` ------^^^))) Policy dor Self-ins. Lha 4: // 7 �p e 7 ii... ) _ Expiration Date:_yy���7/P' 7/ i'7 lob Site Address: �02. '.Q-p'Ve� r !� /017 Ciry/State/Zip: 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 . i Inst the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the 'IA or insurance coverage verification. Ida hereby ce 1 y nde,the pain and petsaitie r erjf that the information provided above is true and correct. if ` Signature: �._ 'y _ 4 Its Date: 9 " 2�( •` 7 1- _„ V Phone a — O( t" I Official use only. Do not write in this area,to he completed by city or town official. City or Town: .-- Permit/License N 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#: ARSSE-1 OP ID:M2 sonar). conorbei CERTIFICATE OF LIABILITY INSURANCE (blab092z2018 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 poticy(ios)must be endomed. 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 certHicate holder In lieu of such endorsement(s). PRODUCER VbZlecT Evan Tobasky Rodman Insurance Agency,Inc. p xE 44 145 Rosemary St.,Bldg A to eeR781-247-78110 iA°'e 1:161-444-9039 Needham,MA 02494-3238 MAn,cess: Evan Tobaskypm INSURER(S)AFFORDING COVERAGE HNC I( INSURER :The Hartford INSURED ARS Services Inc INSURERS:Beacon Mutual Insurance 38 Crafts St _. __ -- Newton,MA 02456 INSIJS RC:NCCI _. INSURER E: ... INSURER F: COVERAGESISTOC CERTIFICATE INSURANCE EBER: REVIMED BOMBER: THIS A CERTIFY THAT Mt POLICIES U EMENTTLISTED CONDITION HAVE BEEN ISSUED TO THE INSUREDHNAMED WITH FOR THE POLICY H THIS S INDICATED NOiY BE ISSUED O ANY PERTAW,REQUIREMENT, U OR CPrF ROED ANY CONTRACT OR sCfr:N Do HEREIN WSURESPECT TO WHICH RMN CERTIFICATE MAYO ISSUED ORF MAY PERTAES THE INSURANCE A HAVF D THE POLICIESE)byP DECLAIMC-0 HEREIN IS SUBJECT TO AI.I.THE IERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMOS SHOWN MAY BEENHAVF, REDUCE)by PAID0/11LP CLAIMS. MR .._ '..A Re D Iwvu VOLILf flI POLICY EYV..... LI —..-. LORI TYPEOFINSURANCE INCD MVO POLICY NUMBER MONYYYY_tMM•• LIMnS I COMMERCIAL GENERAL LIABILITY EACH fY'URrIF.NGG S CLAIMS-MADE I JOCCUR PREMKAS{EAauvttmal 5. .. WScob Myone basun) S _. PERSONAL SNN INJURY 6 GM AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATEb PONOY JECi ILOC PRO. PRODUCTS-C(1MPYJPACG b OTHER AUTOMCB0.EAIAStRT .._.............. M SINGSLIMT ANY AUTO BODILY INJURY(Po:pawn) £ ALL QVRED ••••• SCH ' Ng2"ED BODILY INJURY(Pera Sent) S AUTON NON-DMED PROPERNn�N, F."fE HINLUAUTOS gurus (Per eaidentI UMBRELLA UAL( OCCUR EACXAXVRRWW:[c $ EXOCSS DPS CLAIMS-MADE AGGREGATE S PW I RETENTIONS WORKERS COMPENSATION X(STATUTE I Er ANO EMPLOYERS'LIABILIIY r A ANY PR(w TORlAR N£ruuxacurlvE F-1 (MA) 09124/2046 09f24f2017 Et EACHACCN(ENT S 1,000,000 FBCAIR.A M3EREK UDEOI NIR B Blew mryla NIS 00000E4630(RI 09124!2016 09124t2017 A msEasP EAeNHOYFE S 1,900,000. ttyegdwc'NC.Under DESCRIIPTIW OF OPERAT10N9 below ., EI DISEASE(PODGY LIMIT S 1,000,9010 OESCWPnOH DJOPERATIONSt I.00AHONSt VEHICLES IACOt&r 101,AWtlilwrN RemaNS SCM.YIpmib Ee aSPeJMtlt'mmaspw is(Matted( CT Work Camp bob The Hartford b9972M310 9/24/16-17 1mil/Smit/1mii NE work Comp w/NCCI 9/24/16-17 Lv1/1m11/1mi1 CERTIFICATE HOLDER CANCELLATION -- ARS---- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ARSServices Inc THE EXPIRATION DAIS THEREOF, NOTICE WILL BE Dfl.iVERED IN ACCORDANCE WITH THE PIX.ICYPROVISIOH3. dba ARS Restoration Specialists LLC AUTHORIZES REPRESENTATVE Ne Cron ,T „d Newton,, t SSt 02456 C/alp'/' M 1988.201d ACORD CORPORATION. Alt rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD /--"1 ARSSERV-02 CWOODSIDE AR Cr CERTIFICATE OF LIABILITY INSURANCE DAsnz1zD16 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 pollcy(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 License#1780862 NRON:Cple:DR - - - - Paul Ruozzi InternationalHUB wNew England PRONE j81 792-3285 �IUC,NnI_ 600 LonDrive W4xes pa u _.- _ _ Norwell,MA 02061-9146 gpppE$ei pauLNOzzi@hubinternafiOneLCom INSURER(S)AFFORDING COVERAGE 1 NPICR INSURER',:Nautilus Insurance Company 17370 INSURED INSURER R:Commerce Insurance Company '34764 A.R.S.Services,Inc. INSURER c:Hartford Fire Insurance Company _. 19682 30 Crafts Street INSURER0: Newton,MA 02458 _- - INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: _ THIS IS TO CERTIFY THAI'THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECTTO WHICH THIS CERTIFICAI E MAY BE ISSUED OR MAY PERTAIN, PIE 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. /NSR - - ABOL SUER POLICY NUMBER POLICY EFF POLICY EXP - - - LTR TYPE OF INSURANCE INSD VWD IMMTBNYVY) IMM!MYYYYI LIMITS A X COMMERCIAL GENERALV(LIABILITY EACH OCCLRRENCE 2,000,000 L CLAMS-MADE Lx l UCOUR X X ECP0153788716 09/24/2016 09/24/2017 D'V^AG61 ENTL°.� -100,000 REMISE X BIIPD Detl:$10,000 Mm Exp)Ary we person) - 5,000 X Pollution Llab CPL - PEeaONAL&ADV INJURY 2,000,000 GEM AGGREGATE I/MIT APPLIES PER: GENERAL AGGREGATE 2,000,000 POLICE LXIJECTID- I ,LOC PRODUCTS•COMPIOPAGG 2,000,000 OTHER AUTOMOBILE LIABILITY I COMBINED SINGLE LIMIT $ 1,000,000 ANYAuro X : X 15MMCBGBJWM 09124/2016 09/2412017 BODILY INJURY(Per person) S - pOSNE0 SCHEDULED P(qur IPUrLRV(Pep accident) Sl ALL PROPERTY AGE SX HIRED nuros X AUJED (Per accident) S X OMesew DAR X'OccuR EACH OCCURRENCE $ 5,000,000 A 1 EXCESS LIAR I CLAIMSMAHE X X FFX153788816 0912412016 09/24/2017 AGGREGATE $ 5,000,000 ii EEO REhTION g LVORKERS ON $ R A EMPLOYERS'LIA tt 1 I IGTATII@ CR AN PROP - RACLUDEDXECUTIVE Y EL.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? x NIA - I(Mandatory l NH) I EL DISEASE-EA EMPLOYE_$ l yes,demm under 'DESCRIPTIONOF OPERATIONS below _ : __ E.L.DISEASE-POLICY LIMIT;$ _._.4 C Property(Bailment) 08UUMR06539 .09I24I201fi 0912412017 $950,000 Blanket L-- - -.-_ _-- DESCRIPTION OF OPERARONSI LOCATIONS 1 VEHICLES (ACORD 101,AJJllloml Remarks Schedule,may be attache J If more space is required] CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE A.R.S.Services,Inc THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN (Evidence of Coverage Only) ACCORDANCE WITH THE POLICY PROVISIONS. 38 Crafts Street Newton,MA 0245B AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(20141011 ma Aroma name and l......E.E.n.eli=ee.ew.....,r.....t a rnon ARSSE-1 OP ID:SH 4corro CERTIFICATE OF LIABILITY INSURANCE DATE ^122/002/20162/2016 ` 1 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. It 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 Evan Tobasky Rodman Insurance Agency Inc. PHOFE FAX 145 Rosemary St., Bldg.A 'AINC.NO.Ext. -247-7800 (Arc,No): 761-044-0090 Needham,MA 02494-3238 AECRESS: Evan Tobasky - -- INSURER(S)AFFORDING COVERAGE NAIL• I INSURER A:The Hartford#30104 INSURED ARS Services Inc INSURER B:Beacon Mutual Insurance#24017 ARS Restoration Specialists INSURER C'. 38 Crafts St -- Newton,MA 02456 INSURER 0: 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. NOTWRHSTANDING 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 AULL SUMO POLICY EFF POLICY EXP TYPE OF INSURANCE LIR INS() YND POLICY NUMBER (MMIDDNYTY) (MMODIYYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE DAMAGE/0 RENTED CLAIMS-MADE I OCCUR PREMISES IES occuren CP) MED EXP/Any one perso•I PERSONAL 8 ADV IN JJ¢v GE 'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE POLICY PRO- JECT R6PEGS LOC PRODUCTS-COMPIOP A66 OTHER. AUTOMOBILE LIABILITY COMBINED O BINEDRSINGLE LIMIT acciden ANY AUTO BODILY INJURY(Per person) ALL OWNED SCHEDULED BODILY INJURY(Per accident) _ AUTOS _AUTOS HIRED AUTOS AUUTTOSNNEp PR((Peer ee�TY)AMA3E UMBRELLA LIAR OCCUR EACH OCCURRENCE EXCESS LIAB aLAIMS-MADE AGGREGATE DED RETENTION$ • p� WORKERS COMPENSATION X ER0TH Aw EMPLOYERS'LIABILIn STATUTEER A Aff PRwmEEeESEAARTNE E+ CUT'E YN NIA TH684009(MA) 092012016 09/24/2017 E L EACH ACCIDENT 1,000,000 B Mandatory h NHl 0000064630(RI 09/24/2016 09/2412017 EL.DISEASE-EA EMPLOYEE 1,000,000 /DESCRIPTION OF OP-dtATIONS below EL DISEASEPOLICYLIMIT 1,000,000 DESCork OFOPERATIONS Hartford 2M31ACORD o1,Additional 4/16-17 lmilSchedule,mwl lniili:scrod nmore space I•nOUeadl CT Work Comp w/The Hartford 09972M310 9/24/16-17 )mil/)mil/)mil NH Work Comp w/NCCI /INHARPS 00503 9/24/16-17 )mil/)mil/)mil CERTIFICATE HOLDER CANCELLATION ARS-- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ARS Services Inc ACCORDANCE WITH THE POLICY PROVISIONS. dba ARS Restoration Specialists LLC AUflORIZED REPRESENTAWE 38 Crafts St ^„ Newton,MA 02456 (/�bY/' Oo 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD Filen BP-2017-I262 APPLICANT/CONTACT PERSON A R S SERVICES ADDRESS/PHONE 38 CRAFTS AVE NEWTON (413)272-0101 PROPERTY LOCATION 46 GRAVES AVE MAP 32A PARC 'I 083 001 Z NE URC 11t / THIS SECTION FOR OFFICIAL USE ONLY: PERM! 'APPLICATION CHECKLIST ern REQUIRED DATE ZONING FORM F , LED OUT Ili Fee Paid ail MW Buildin_Permit Filled outamare Fee Paid Ty000f Conswctign: REMOVE WET WALLS&INSTALATION FROM AFFECTED ROOMS IN 1ST&2ND FLOOR-REMOV` DEBRIS&STUDS ON 3RD FLOOR New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 094878 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 I Iealth Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission Permit DPW Storm Water Management Demolition Delay Signature of Building Official 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,Departmenl 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. AFFIDAVITS IN SUPPORT OF PERMITS FOR WORK AT THE GARDEN-SIDE CONDOMINIUMS AT GRAVES AVENUE 46-50 GRAVES AVENUE, NORTHAMPTON I,Gratienne("Sienna")Baskin,co-owner of 46 Graves Avenue,Unit 1,Northampton,MA,authorize ARS to complete its required work, including demolition work,in my unit,and ask that they do so in a workmanlike manner.Our insurance company hired ARS to do emergency work in response to a fire that happened at our property,located at 46-50 Graves Avenue, Northampton (a three condo property), on April 18,2017. Please contact me at 718.662.6086 if you have any questions at all.Thank you. Gratienne("Sienna") Baskin I,Christa Douaihy,co-owner of 46 Graves Avenue, Unit 1,Northampton,MA,and spouse of Gratienne Baskin,authorize ARS to complete its required work, including demolition work, in my unit,and ask that they do so in a workmanlike manner. Our insurance company hired ARS to do emergency work in response to a fire that happened at our property,located at 46-50 Graves Avenue, Northampton (a three condo property),on April 18,2017. Please contact meat 917.208.5829 if you have any questions at all.Thank you. Christa Douaihy I,Janvier Rollande,owner of 48 Graves Avenue,Unit 2,Northampton,MA,authorize ARS to complete its required work, including demolition work, in my unit,and ask that they do so in a workmanlike manner.Our insurance company hired ARS to do emergency work in response to a fire that happened at our property, located at 46-50 Graves Avenue,Northampton (a three condo property),on April 18, 2017. Please contact me at 207.522.7576if you have any questions at all.Thank you. Janvier Rollande I, Frank Sleegers,owner of 50 Graves Avenue,Unit 3,Northampton,MA,authorize ARS to complete its required work,including demolition work,in my unit,and ask that they do so in a workmanlike manner. Our insurance company hired ARS to do emergency work in response to a fire that happened at our property, located at 46-50 Graves Avenue, Northam• • (a three condo property),on April 18,2017. Please contact me at 413.687.3091 if you have a qu: tions at all.Thank you. fnk S reger Sworn to before me on this2-T day of April 2017 LANCE PIANTAGGINI NOtary .20118 •COMMOW*EMWAS:HUSnTh � May M.2018 ppGE W/01 HPNrAFUPA AFFIDAVITS fN SUPPORT OF PERMITS FOR WORK.AT THE GARDEN-SIDE CONDOMINIUMS .AT GRAVES AVENUE 46-50 GRAVES AVENUE,NORTHAMPTON I,lanviertiollande,owner of 48 Graves Avenue, Unit 2,Northampton,MA,authorize ARS to complete its required work, including demolition work, in my unit, and direct that they do so in a workmanlike manner. Our Condo Association s insurance company hired ARS to du emergency work in response to a fire that happened at our property, located at 46-50 Graves Avenue, Northampton (a ;hive condo property),on April 18,2017. Please enable them to pull necessary permits as soon as possible for their work. Please contact me at 207.522.7576 if you have any questions at all. Thank you. / C) _� 1 GrnYrri✓ �ogam-t1,7 JANVIER ROLLANDE April d6 ,2017 r(' On this date, before me, the undersigned notary public,personally appeared • NMJ6 • 11 _46r,61 _,proved to me through satisfactory evidence of identification which was 1/461 lie /,1-rvri L ,4 , _ p/4At'-to be the person who signed the preceding document in my presence,and who swore or affirmed to me that the contents of the document are truthful and accurate to the best of her knowledge and belief and that the signing of the document was her free act and deed. Notary Public My'commission e irc TIMOTHY 1.WELCH Notary aortic - • ;eine My Commission Ewpfres Apr 2a.2019 AFFIDAVITS IN SUPPORT OF PERMITS FOR WORK AT THE GARDEN-SIDE CONDOMINIUMS AT GRAVES AVENUE 46-50 GRAVES AVENUE,NORTHAMPTON 1, Christa Douaihy, co-owner of 46 Graves Avenue,Unit 1,Northampton,MA, authorize ARS to complete its required work,including demolition work,in my unit, and direct that they do so in a workmanlike manner. Our Condo Association's insurance company hired ARS to do emergency work in response to a fire that happened at our property, located at 46-50 Graves Avenue, Northampton (a three condo property), on April 18, 2017. Please enable them to pull necessary permits as soon as possible for their work. Please contact me at 917.208.5829 if you have any questions at all. Thank you. Christa Douaihy April 26, 2017 On this date,before me, the undersigned notary public, personally appeared C. ho-4,..41, proved to me through satisfactory evidence of identification which was N 99 fk ,t,'S I,Leh Ve to be the person who signed the preceding document in my presence, and who swore or affirmed to me that the contents of the document are truthful and accurate to the best of knowledge and belief and that the signing of the document was her free act and deed. SUSAN GR BERG Susan Grossberg,Not Public Commeatdilasstdueft My commission expires: Nov. 23, 2023 Commission Expires Nov.7312023