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25C-055 (8) 41 LINCOLN AVE BP-2017-1341 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 25C -055 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: window replaced BUILDING PERMIT Permit# BP-2017-1341 Project# JS-2017-002224 Est.Cost: $3520.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: SERGIY SUPRUNCHUK 104327 Lot Size(sq.ft.): 16509.24 Owner: MORGAN BARBARA&JANE AULISIO Zoning: URB(100)/ Applicant: SERGIY SUPRUNCHUK AT: 41 LINCOLN AVE Applicant Address: Phone: Insurance: 536 EAST MAIN ST (413) 883-3802 WC C H I C O P E E M A 0102 0 ISSUED ON:5/22/2 07 7 0:00:00 TO PERFORM THE FOLLOWING WORK.:REPLACING WINDOWS ON 2ND 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# 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 5/22/2017 0:00:00 $40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner a 'Nity of Northampton a ,g § It 1 BOJ ,"tiding Department s'� '� `" `"_ \ 212 Main Street - Room 100p.t,� �. "` �i� - Northampton, MA 01060 ;atans - ,, v phone 413-567-1240 Fax 413-587-1272 ' `- ,.TA car-, �� o �,. 4,10.? APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE/ OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION/ 6'-17-/3 CI� y3 i 1 w e Q/ G c ] Thls section to be completed by office 1.1 Property Address 'ry ,(ThI �/� � �A[...-, Map 076 C.< Lot' 0� Unit Nor 1R/AMJ ,'� A/M Zone Overlay District V// Elm St DISMct CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 cater of Record9 J0 & ; a iOn< y3 1 ii. vein Ave Name(Pint) Currenttaili gi dr 8.„7 n7 % 7 Telephone Signature 2.2 Authorized ent: Name I��t� /�� '/1 GIM C Current Mailing Address: g / q/3eP33S© 2 S Telephone SECTION 3- 'LA ED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1 Building 3--C201 S2i/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) Check Number /f/ (PCThis Section For OKcial Use Only _ Building Permit Number Date _ - _ Issuu ed: Signature Aler / 5—27/ 9 err Su.mg Commissioner/Inspector of Buildings Date Te / . 36 C� 1A/a , �� d ct.J,�' Ovl'vS 1� F�2 �//�, A IPSection 4. ZONING All Information Must Be Completed.Permit Can Be Dented Due To Incomplete Information Existing Proposed I Required by Zoning This column to be tilted in by Bushing taTanmere Lot Size _. _. .... .._ Frontage _. _. _.. Setbacks Front . Side L R -- L:_,_ R Rear __.. Building Height "_" Bldg. Square Footage • ?A Open Space Footage % _ _ -- Rtureamivusbldg&paved S #of Parking Spaces _ .. (volwne&Location) A. Has a 5 tat Permit/Variance/Finding ever been issued for/on the site? NO DONT KNOW 0 YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DONT KNOW O YES IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO 1457.2i4 DONT KNOW O YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained O , Date Issued: C. Do any signs exist on the property? YES O NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES O NO b( IF YES, describe size, type and location: E. WH the constructor activity disturb(deanng,gradin ,ex aton,or filing)over 1 acre or ten part of a common plan that will disturb over'facie, YES O NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing ❑ Or Doors D Accessory Bldg_ ❑ Demolition ❑ New Signs [0] Decks [p Siding[CJ Other Brief DCscriptipoptrrh c Q mi!j^-'/� cee�t-S r Work: IC Gl C.X— �/J �%JFA r tJ VV �/ /,un Alteration of existing bedroom Yeo Adding new bedroom Yes C� / 0 r�� Attached Narrative Renovating unfinished basement Yes X No Plans Attached Roll -Sheet ` 6a.If New house and oradditt -str • housin• c•- •lefeAhe �.=;i'd•: a. Use of build • : 0,- Famil Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction i. Is construction within 100 ftof wetlands? Yes No. Is construction within 100 yr. floodplain Yes No I. Depth of basement or cellar floor belowfinished grade k. Will building conform to the Building and Zoning regulations? Yes No I. Septic Tank City Sewer Private well City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FORBUILDINGPERMIT 470C-- �� i ,as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date u'6' ,as Owner/Authorized Agent hereby deci thastatements aril formation on the foregoing application are true and accurate,to the best of my knowledge and belief. C/ / Signed un3ffikaksaee :Itie. •f perju•• f''i Print Name 4f7 .410111 afir Signature• •er/.far Date rat , SECTION 8 CONSTRUCTION SERVICES ;.1 License. struction '.-na isor: Not Apia ble £ 213 it Na of Licwgg Notder: r J ifs, C.ffn e e 0 4-5 License Num•er Address f ! r 'lir i Expiration.ate Telephone 9.R.. h<..u, .1m. .yauC. sir. Net Applicable £ Company Narrt§ Z ( Registration Numbs � C oa r9 / 9 Add -ss Expiration Date SECTION 10.WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§25C(69 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 £ 114R11ome Ovener Eiemotiort The current exemption for"homeowners"was extended to include Owner-emoted Dwellings of one(I) 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 an&or farm structures.A person who constructs more thap one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official that he/she shall be responsible for all such work performed under the building permit As acting Construction Supervisor your presence on the job site will he 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 u!M..--Mit- Office of Investigations -7111''= ti la =tear _a 600 Washington Street ='lid= 4 Boston, MA 02111 •. 5'o-1.00 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information lease Print Le ibly Name (Busivess/Organizad /I onndividual): L/� SCO Q4-. Address: rPJ e7 S S 4 or , OA- ..-4,0. r�R � 43 90 City/State/Zip: Phone #: �l Are a an employer? Check/ • appropriate box: Type of project(required): 1 I a employer with ` 4. ❑ I am a general contractor and I YP p I ( 9 ) employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction listed on the attached sheet. 7. ❑ Remodeling 2.El I am a sole proprietor or partner- ship and have no employees These sub-contractors have g. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance. required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1 L Plumbing repairs or additions myself workers' right of exemption per MGL G1//% Y [No comp. 12.0 Roof repairs insurance required.] ' c. 152, §1(4), and we have no , ,I":employees. [No workers' 13.'�Oiher r v,.,,,, comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. tHo meowners 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 subcontractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing worker 'compensation insurance for my employees. Below is the polity and job site information. t Insurance Company Name: AeA 1 ,pp( INS ran PP eona_ ` Pr Policy#or Self-ins. Lic. #: ik ) A h 1 O Expiration Date: ( , - / Job Site Address: II 3 L t ems//l gVe_ City/State/Zip: /170f r a ' : . iti Attach a copy of the workers' compensation policy declaration page(showing the policy number and expira on date).A.4 A 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 co, age verification. Ido hereby certify 4.enalties of perjury that the information provided above is true and correct. Si: ature:� n - / Date: 7 Phone#: y/ s •c5 3 8 D 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 t1 16 �'�r Massachusetts �. i. ��r�i ( .t ig 4 DEPARTMENT OF BUILDING INSPECTIONS 4\1 x . ,`f 212 Main Street • Municipal Building s`1 0C Northampton, MA 01060 10i a"lig INSPECTOR Louis Hasbrouck Chuck Miller Building Commissioner Assistant Commissioner HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her construction supervisor. The state defines"Homeowner"as, " Person(s) who owns a parcel on which he/she resides or intends to be,a one or two family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two- year period shall not be considered a home owner." The building department for the City of Northampton wants any person(s)who seek to use the home owner exemption, to act as their own construction supervisor, to be aware that by doing so you become responsible for compliance with state building codes and regulations. The inspection process requires that the building department be called to inspect work at various stages, which include foundation/footings (before backfill),sonotube holes(before pour), a rough building inspection (before work is concealed), insulation inspection Of required) and a final building inspection. The building department requires these inspections before the work is concealed, failure to secure these inspections can result In failure to obtain a certificate of occupancy until the work can be inspected. If the homeowner hires other trades to perform work (electrical, plumbing &gas)the homeowner will be responsible to make sure that the trades hired secure their proper permits in conjunction to the building permit issued, and that they get their required inspections. Failure of the individual trades to secure the permits and inspections as required can DELAY the project until such time as the proper permits and inspections are made I, understand the above. (Home owner/resident's signature requesting exemption) I will call to schedule all required building inspections necessary for the building permit issued to me. Date Address of work location 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 Ave 111, S 150A. Address of the work: 1'/3 L i e p l , A The debris will be transported by: t® / S ,1�eD S� l� The debris will be received by: C7Je a k µ70S Building permit number: �/� ( Name of Permit Applicant �(/ iy,0A4 /47 / re 0C//9/7- 1 Date Signature of PF, mit Ap,v ant r, Wlll 1fje AP home improvement contractors and hnhxtms engaged In TYYa"' '"''ahome improvement contracting,unless of ally exempt hom �y� registration by Provisions of Chapter 142A of the general laws, ah{rgl}>offal must be terad with the status should of Mere t of }alp l V,1Cl V D44( Inqui3ies about registration and status should be made to the d Director. Home Improvement Contract Registration, One emmeuevtime imioneeswienvireern /P 4.01110104 >l\\\ Ashburton Place,Room 1301,Boston,MA 02108(617)727-959$ illibielaillgin"as q.,5 Q.: Chicopee,MA 0102 a .,3 Phones:1413)883.3802 '+.... Fax(413)331-4358 4357y08 can pay more,but you can't buy bettelr MA LIc435A238 Cr Lid1063584T www.ABianceHonnemc.tnm ifif a [[ �7./p(� SUBMITTER TO: eel 13 bOa Phone: Cell: 203-6.27Z - 7 72 VD L4. ..,ntow. N Email: We he -i: lobo*specification performed and ii• eMmates for r.rK to be performaterials to • used:. { „eve c.c.. g . .v s ,._. .. lfIIIMIIISIRnA IIIIILIMIIIIfillSl seinasiIIIIIIIninini WSIIIIIIRISIULVM.[' �• • ^ '7_Ailf[_'� MPFINIIMNIIIOIMNMIIILVJFAIIIIWZSSIMIIIMPS mat aa• seya811111bT:a+zl /lrlty. irallIMIll_Ewt[►.a1itiailla-'S I111111MillaiMIN , healij..i.m Tri_ ❑ ❑fdiFa aTrim ❑Fat Coli QPVC Colt QG$Coii Cabs. ❑Corners Color: HINDOWS rids. ES ONO ['Flat OContour olonlal 0Diamond ['Other: ow many? D(NQ PIC_ 0215_ 0 3(5_ 0 Csmt_. 02Lt/Csmt_ J3Lt(Csmt_ !!['__AWN ['HOP_ Q BOW(4 or 5lines) ['Bay Full Screen:['YES ONO ['Wood grain Interior: Color: Exterior Color:OYES ONO Color: Mull:OYES ['NO ['How many? OGlass Option: Type: Q ClimaTech 0CIimaTech TK2 Q ClimmaTech TG2 Q ENTRY DOOR:Q YES O ['Type: 0 Style: o STORM DOOR:0Y O ['Type: 0 Q Material Location: 0 Waste Disposal: WORK • A• ;i I. • .. • _Te tnlbwln&sNedukwwl be adhered to unMe drrae 4ea the 2r alJga lance: Ar f abi*hen ceuw MINIM eemMd won. . V a/ r Gni{. whip mnAm*Mt ew raWlNu+r eaarykra4 . may nIX.-:. �, both packs havemafeda{IS elewtedwept"ofthe mntci.,M Three Symg:Mn Knurl lm espied.Th,Ownert,ebvahnowleeeeSand won That the WeoillrafAttu ma apgmimie secant *laws that ape not awR46 the Contractor lnclu g,but not limited m Mkes,Ms of(ud,shortens otmaNno,arrinanta and all other Merit beyonl8 contra!,shell mum wderedaeviolt1ma �a \l MmYRrAiahNrr Y rano',eras oterwiseyrWfled by menu/attar.Labor and.Mmanshlp have a warranty done fun year hum the date of woman, Al wadi to be completed I awokmanlltr maner according to,t.ndard pratlke.Any aheratio.,or deviation hon the above sper.lfitlalloralnvolvingtM costs will be executed only upon written orders,and will become an mora tarp Werand above the estimate. ' PAYMENTS We propane hereby m furneh main* .. 'cam=ete in •y. nee with hymens to be made et Man: eboveywd�s7zforthe mof: 7441.1.► d ;04 1Own 3 S 2-3wpw cnnnct VT G ,J"i1. .1Pf7Ja %IS I upon infirm of materlalu ,ir '� %{5 Iwampkem: Nameor Salesman �/P/ Ini/ �NS hell be max fonnwnn upon • � ��r� .. . mowers ti r uanwua Authorized Sgnature 40till ,hi. Tnetwomerh.w ��_sr by understands yrwmWy be applied to 13%pernone tor pttn to oil rate cm mole ver xde+aukt / Cr � .nts whAI lamina earvedattwOdry,anealltons ndewyknuW beakainmm unpaidfinance thaws as Wou4tlMingbabM4.IntheevemMdd/auh,neiuneeerhy aMaaMsmp.v "adbrbnbaM eNatandbt indebvtmu.all tons vuWtswltt.mYuil irdWo{reuonbk attonefs fees. AcOpance of Pragsal:I have read both flet of this document and:wept the prices.specification and conditions Raton.!understand that upon Aping,Mb proposal Meosnes a binding corona You as aNbrled to do work as specif d.Payment'mal be max as outlined above.YoutM&uer,may cancel tttransaction at any time pba bmanight it to 3rd brines day after the date ofthaNroSon.Cancellation must be bre nentim DO MN TIM i. a.. n• WIRER'ME ANY MAIM SMCES. ' l'i 40-Zany Signature ,_ Date v Signature Date Y ICE a Al _ a MAY CANCEL NIS TRANSACTION,WPIHOUT ANY PENALTY OR ORLIGA11ON,WIININ THREE BUSINESS DAYS FROMTIF MOVEDATE.IF YOU CANCEL,ANY PROPERTY TRADED IN,ANY PAYMENM MAOEBYYW WOOER THE CONTRACT OR SALE,ANO ANY NEGOTIABLE IKIRUMENT EXECUTED BY YOU WILL OE RETURNED WITHIN TEN BUSINESS DAYSFCUOWWG ANEW!6YIHE SBLEA CPYOURiANCSAAn ON HOME,NORM SECURITY MUM OUT Of TNETMNSAQ ON MUM WKELLEa TO CANCEL T WSTMNSACTION,MAR OR MINER A$GNEO ANDOATED COPY OF This CANCELLATION NOTICE OR ANY OTHER WIRIIEN NOTICE,OR SEND ATELEGRAM To:ALLMNCF HOME IMPROVNAFM,DC,53E MST MATS St ORCOMG MADIAEO ......�.....�._ (One.SVdfy as hsdkleys e#bkd} I ttERSBY morn nos TRANSACTION (eryes Sliratlgai • C�fie Wnvinontaea o/C-%gaaaacAiaaettd ' n1' Office of Consumer Affairs and Business Regulation 10 Perk Plaza-Suite 5170 Boston, Magf iueetts 02118 Home Improvemetlt'Ecfltractor Registration TYPs m A49hhe8olc 160218 ALLIANCE HOME IMPROVEMENT,INC BSllmaan: 02/19/2019 375 Chicopee St Chicopee, MA 01013 Update Adan and ntim and. Mab roam ter change. OM1 a za.aall ... ❑Adds. R Rs,ass,Y n 0111Na Canner AIM. �YrO agulan M.. IMO IMPROVIMU1T CONTRACTOR Myalnton valid la lnevlael Ilea any TYPd Caperalke bean the=paean dales O Med return su MOO aftansanarMWsnd easiness P-, •Nin 04/199010 10 Pak Ram-Sults 7a Basica,MA Mit A4LANCE NOMISPRIMOVHAENT,INC SOON' aloesset - cnkmpeeMA C — olola Undersecretary d without tfleR0t0r0 • HMassachusetts Department of Public Safety ' Board of Building Regulations and Standards License CS-104397 sEMMY SNPRUNC1aNt ci EASTMANilRBEr. *: ' CNCOPEE MA b/0Y0 N1 CA-:- Expiration: Commissioner 11121/3617 A`C &?S CERTIFICATE OF LIABILITY INSURANCE ohm mowoDDii I 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 TEE COVERAGE AFFORDED BY THE POLICIES BELOW. TMS 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 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 such andaruament(s). MHTAIT Paesucart NOR&Neta insuranceAgency Inc e -a6i3�T32A137 sax het&7316629 662 Riverdale 5trnt w Enr i trac,Nm. ____., West Springfield.MA 01089 "AIL eO: dlggneilllnssDm INSVnRM AFFORDING COVERAGE I. NAtC5 INSVRER A: $t810 AVID n5Vr8111:e Companies $TA _. ._,._.._ .._ INSURED Alliance Home Improvement.Inc mune e. Safety insurance Company I 39454 Sergey co pee Street w$vRuc. Acadia Insurance Company -1— A0235 375 Chicopee Street --- ---- _ - - - Chicopee.MA 01013 INSURER 13; _ --- _I ...— INSURER A .._INSURERA COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED SELOW HAVE BEEN*SUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTMTHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH TITS 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. AM- TYPE OF INSURMIce MaooA usar -7 A F I PoLICYE HVn l 5283 E0. I 1 r ) wars A ;Aj'eoMMMrCYLsexeBAl ISM .P�26bB283 G3i1211017 03/12I20t0 .aAGN000W ono 5 1.100.000 CLaIMs.MACE .. `P�RELIE"al_._• _ . OCCUR { 5 100.000 � � ,MEG EXP IAM Pro Nam, IS 5.000 I PERSONAL..ADV INJURY S 1,000.000 GEHL AGOPEGAYE LIMIT APPLIES PEPi GENERAL AGGREGATE I5 2.000.000 1 'PEAK _;ac 1 LOC I :PNLWCTS COASHOPAGG j5 2000000. Oruelt15 B ;AVTOMO98e LM81UT 16226463 12/04120018 112104/2017 IpL1eINED SINGLE OAT i$ 1.000.000 I LE._RRm lenn INJU _ r___.. ANYAOTQ BOOL INJURY INN MS I S — ONNEp SCHEDULED ' F1 BOOLT snuffyR'NwRt Y oM5 no�ODSINa.Y AUTOS'7 GVN ._EO ( PROPERTY DAMAGE_ AUTO$GIAti AUtCS ONLY 1 •,LPge ynlL S .:UMRRELLA LYSt1 �I camEAGH OCCURRENCE 'S �MESSIAH' 'CLAIMSMADE. AGGREGATE 5 DEO El RS5E5:51O515 - 1 � (pEp 5 C' .v1GPXB150YC0�$$'EAIiON I MAARP300625 12105/20/6 112105f2017 _Y_3TAMF :_EP.ASMISAPL .... _ . AN1'PROn18TGAPMTNER,ERECUTIVE YIN I 'EL EACH ACCIDENT $ 500.000 OFFICn,nMnRE%CLUOEDO �'., IMpmdnnry In MI) I ,E L DISEASE•EA EMPLOYEE 14 500,000 oFCRIPPON OF OPERATIONS men. EL DISEASE-POLICY LIMIT I$ 500.000 DESCRIPTION OF OPEMTONS I LOCAtIONS I VEHICLES IACORO IFI,Addl0555l Romana schedule may G MHOS II MON pawb nquI*SI CERTIFICATE IS FOR PROOF OF INSURANCE PURPOSES ONLY CERTIFICATE,HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE OANOELLBO BEFORE Alliance Home Improvement Inc THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN Sergey SugmnChuk ACCORDANCE mem THE POLICY PROVISIONS. 375 Chicopee Street Chicopee.MA 01013 AUmmdzaoRaM E11988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD