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31B-160 7 Langworthy Rd h5 tart KITCHEN RENO/P0 H MBP-2018-00157 GIS#: COMMONWEALTH OF MASSACHUSETTS MJS-2018-000227 CITY OF NORTHAMPTON Map:Block:Lot PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Pemin:Huilding DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# MBP-2018-00157 Project# MJ S-2018-000227 Est.Cost: 175300 Fee:1139.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: THOMAS DADMUN CS-107919 HIC- 179682 Lot Size(sq. ft.): Owner: LAMB MARGARET A&CHRISTOPHER F CLARK Zoning:URA Applicant: THOMAS DADMUN AT: KITCHEN RENO/PORCH Applicant Address: Phone: Insurance: 60 SCHOOL ST (413) 387-7381 MPT4694Q HATFIELD, MA 01038 ISSUED ON: 08/16/2017 TO PERFORM THE FOLLOWING WORK: Re-module Kitchen, new windows, enclose screen porch and breezeway, replacement windows, bookshelves in basement** INSULATION REQUIRED PER MASS ENERGY CODE AUGUST 2016 AMENDED 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 ofOccupancy signature: FeeTvpe: Date Paid: Amount: Check Number: Alteration 08/11/2017 1139 789 212 Main Street, Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner „-- File#MBP-2018-00157 APPLICANT/CONTACT PERSON: THOMAS ')ADMUN 60 SCHOOL ST HATFIELD.MA 010 ! (413 : -7381 4 PROPERTY LOCATION tOr.OCEr 2 THIS SECTION FOR OFFICIAL USE ONLY: 41k1 _ PERMIT APPLICATION CIJEC 1ST ENC 0 SED R,1 UIRED DATE ZONING FORM FILLED OUT Fee Paid $1139.00 Building Permit Filled out ‘V Fee Paid '.1139.00 Typeof Construction: Re-module Kitchen,new windo s,enclose scre-,Arrch and breezeway,replacement • windows,bookshelves in basement /VOTE- • • ' IO 11...6( to.p..6 bPER_ MAU k(rti 01'6 New Construction Non Structural interior renovations A(4.crr 2e)IL ci4„,tovet4 Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFy RMATION 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 Demolition Delay 1 II/ Signature of Buildi g 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,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. r/` � �� ' , U ty cif Northampton P` t /4f �" �) uild'ng Department CurK P 4,, , , d ' f r 21 Main Street � � '47'f ! . , ./ / . �. �� f Room 100 �� ' /. � i -- ort mpton, MA 01060 T ,`° *" 1's Hifi phone 413- 7-1240 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: This section to be completed by office I-A(l ao0p.ni-i PD. Map Lot Unit 4©(Z-(}}AMF fTitjt Mik 610 teO Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: 1v1 ISP) Cti4t rit#il- Chva/ '7 I--,i, &t,�4,,z. P-P. Name(Print) Current MailingAddress: n 74 °� f /' , 44t, 3� ZO J //1( r/ri � . t f`iiii--� Telephone Sign turel 2.2 Authorized Agent: T1,oVAA5 VADMur ) (QC Sahn%L S (, 1— ,+ t -n A ©( 0 3Z Name(Print) Current Mailing Address: / 1 h Signature .,t t^-11: 415- 3 b 7- ! 5�1 1 Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 4 15 Dibo0 E u (a)Building Permit Fee 2. Electrical 4 9 ' fio b; (b) Estimated Total Cost of ( Construction from (6) 3. Plumbing 4 5 250 , `' Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection �l's2 D '` // 6. Total=(1 +2+3+4+5) 1 ( 5a 'baO. • Check Number /,g / /_ This Section For Official Use Only J ��' Building Permit Number: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date 4C.)'Act. 0 (( (A Vvt iN ct L, c (O M EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) _ - ^ Section 4. ZONING All 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 7-- --'-- - - -----1 ---- ------l � -- - -- - - -- l Lot Size �-------------` [-- --- ----- ----Frontage Setbacks '----'---------� ^' -- ------ ---- �----- --' --' -- -� Srrbocku Froot F---| �-- � F---' r--� �—� �-- �-- F--Side L:L: K:�__- Rear Building Height [---� F---| F---! Bldg. SquarFootage Open Space Footage (Lot area minubldg&pave parking) #of Parking Spaces �--- �--- "---� Fill: ---------------7�--------- -- - -7F-'---- ---- -- � � (volume&Location) �--------------- ^------ --- --- --'--- -- -- A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DONT KNOW YES «�� IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO ^��-� D YES �~� ""-,�`°`` �� IF YES: enter Book | ! Page/ and/or Document# ' B. Does the site contain a brook, body ofwater orwed ��wetlands? NO �~� DON'T KNOW YES �~�� IF YES, has a permit been or need to be obtained from the Conservation Commission? r -- -' - - obtainedNeeds tobeObtained 0 Date \~x�� Ob� , Issued: �� C. Do any signs exist on the property? YES �~�� NO ��/ � -- -- -- -- ---- - l 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 YESdescribetypeand Location: | | size, E. Will the construction activity distur (clearing,grading,excavation,cvfilling)over 1acre orisdpart ofocommon plan that will disturb ove1aoa? YESK�� NO K�� 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 ED Addition F—1 Rep|acmmentVV��owo Alteration(s) ��| RoofingF-1 ng Or Doors �� Accessory Bldg. Demolition New Signs [[]] Decks [[] Siding [0] Other[0] B,imfDouoripUonnfpmpoaad ��vpt� ��C�4} t�cL'��Luv�'^^9�`�^), �.u�4�� C��Li,, P017.4.4,4hp-)pA ��pm^» ^� Work: brLth-uotei U`oVouY)/ Awo ftW imsk,p^6oy' Alteration of existing bedroom Yes |( No Adding new bedmom Yes XNn Attached Narrative ' Renovating unfinished basement Yes )C No Plans Attached Roll Sheet 6a.If New house and or addition to existing housing, complete the following: a. Use of building :One Family 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 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 Private well City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT |. �l/hank'KT ��At4 as Owner of the subject property hereby authorize -1161/44\/6 ib)*" to behalf, in || matters relativeto k authorized by this building permit application. Sig ture f Owner Date ~+«l � VA-ON/WO�m«� . aoOwne�Authohzed Agent hereby �declare that the statements and information onthe foregoing application are true and accurate, 0zthe best nymyknowledge and belief. Signed under the pains and penalties of perjury. v ~F/L � . ( �o*t�^� �8�k,+~] pnntwomo+ / ' K � /- )(7 %` \-7 Signature of Owner/Agent Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable El Name of License Holder: IffiDAA-5 1)irDtAAJ C-60 t()Tut! License Number (CID pu,o) olob6 q/A'11017 Adld rle 415 -br_756 Expiration Date Signature Telephone 9.Registered Home Improvement Contractor: Not Applicable El 1t - 6-00i) LLC CompanyName Registration Number (aokoLSC . Address Expiration Date kt4D(obb Telephone q15-30-7.551 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 0 No 0 City of Northampton Massachusetts F... 0. !41' VA DEPARTMENT OF BUILDING INSPECTIONS / 212 Main Street • Municipal Building Northampton, MA 01060 j'1;PV '11`.)0 AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application The Office of Consumer Affairs and Business Regulation("OCABR")regulates the registration of contractors and subcontractors performing improvements or renovations on detached one to four family homes. Prior to performing work on such homes, a contractor must be registered as a Home Improvement Contractor("HIC"). M.G.L. Chapter 142A requires that the"reconstruction, alteration, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units....or to structures which are adjacent to such residence or building"be done by registered contractors. Note:If the homeowner has contracted with a corporation or LLC,that entity must be registered. Type of Work: 14049 ILA/ Fic4.5 VM97 Est. Cost: 4itoo Address of Work: 1 140-)(,00/414-1 Oft.rvi-rw ell,1'3) 111) f ti CO Date of Permit Application: /.'")('( 2.01 I hereby certify that: Registration is not required for the following reason(s): Work excluded by law(explain): Job under$1,000.00 Owner obtaining own permit(explain): Building not owner-occupied Other(specify): OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER M.G.L.Chapter 142A,SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION. Signed under the penalties of perjury: I hereby apply for a building permit as the agent of the owner: d9,IPA1 111-0,Ae, f. Dm)1,t,i,u k)bl Date Contractor Name HIC Registration No. OR: Notwithstanding the above notice,I hereby apply for a building permit as the owner of the above property: Date Owner Name and Signature City of Northampton Massachusetts DEPARTMENT OF BUILDING INSPECTIONS � 212 Main Street *Municipal Building Northampton, MA 01060 -��, ,1^�r Debris Affidavit Disposal 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. The debris from construction work being performed at: 'ai^ ` ' - ' ' v ` (Please print house number and street name) Is to be disposed of at: (Please print name and location of facility) Or will be disposed of in a dumpster onsite rented or leased from: � _ � ^ M��dn�� / � (Company Name and Address) ^ � 1,„i„,...___ ��/A /��/�`vr i v~»~~~~� ^�� ' /"- ' / Signature of Permit Applicant or Owner Date If, for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the Building Department as to the location where the debris will be disposed. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations =m1111= 600 Washington Street ,r site= Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): TA—D Lbi t•-) Address: to 0 JUVOLS City/State/Zip: ii-Alf1P-D PI A 61.03 Phone #: - 3 b7)- 3 8 Are you an employer? Check the appropriate box: Type of project (required): 1.E 1 am a employer with 4. 7( 1 am a general contractor and I 6. LI New construction employees(full and/or part-time).* have hired the sub-contractors 2.0 I am a sole proprietor or partner- listed on the attached sheet. : 7. Remodeling ship and have no employees These sub-contractors have 8. LI Demolition working for me in any capacity. workers' comp. insurance. 9. E] Building addition [No workers' comp. insurance 5. 0 We are a corporation and its 10.ji Electrical repairs or additions required.] officers have exercised their 3.1=} I am a homeowner doing all work right of exemption per MGL ll. J Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4), and we have no 12.[ Roof repairs insurance required.] t 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 their workers'comp.policy information. 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 14 or Self-ins. Lic. #: Expiration Date: Job Site Address: 1 If,ik)(iN k ' City/State/Zip: MOF—TbiA IAP 115 13 iiktk. opeo 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 certi y under the painsrnd penalties of perjury that the information provided above is true and correct. Signature: Date: (Ct 12.0(7 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#: AC© DATE(MM/DD/YYYY) ACCERTIFICATE OF LIABILITY INSURANCE 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 Susan Fleury, CIC, CISR King & Cushman Inc. PA/CNNo.Extl: (913)584-5610 FAX No):(4131584-9322 P.O. Box 447 AIL ADDREss:SFleury@KingCushman.com 176 King Street INSURFR(S)AFFORDING COVERAGE NAICe Northampton MA 01061 INSURER A Main Street America Assurance Co. 29939 INSURED INSURER B: DADMUN DESIGN & CONSTRUCTION INSURER C: _ 60 SCHOOL ST INSURER D: INSURER E HATFIELD MA 01038-9747 INSURERF: COVERAGES CERTIFICATE NUMBER:CL16121401819 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 SUER POLICY EFF POLICY EXP LIMITS _LTRINSD WVD POLICY NUMBER IMM/DD/YVYYI (MM/DD/YVYYI X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE X OCCUR PR �TRENTEO PREEMGEMISES(Ea occurrence) $ 500,000 t4PT4694Q 11/13/2016 11/13/2017 MED EXP(My one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY 11,171: LOC PRODUCTS-COMP/OP AGG S 2,000,000 JEC OTHER: Identity Recovery $ AUTOMOBILE LIABILITY COMBINED SINGLE UMIT $ (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 S EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I RETENTIONS S WORKERS COMPENSATION AND EMPLOYERS'LIABILITY V/N PER UTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) EL DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I 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 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE P I PROVISIONS NOW}IMAN• AUTHORIZED REPRESENTATIVE 1�/ I A 1)3 'A f� • 'dUl 1 Yl�l ©1 • •• o- • • : •• : O .: All ri;hts resltrved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD 1NCnoc ron.nn., dille C6'' _ /./ olytvrtowttleaatA r2/ /CH Ale,t&JacAt,6e.14J Office of Consumer Affairs and Bfisiness Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 179682 lc,' t.t. Type: LLC Expiration: 8/28/2018 Tin 419291 THE TUCKER GROUP LLC. THOMAS DADMUN 60 SCHOOL ST HATFIELD, MA 01038 , ,y1 Update Address and return card.Mark reason for change. — Address " Renewal — Employment - Lost Card SCA* 0 tY0t,A 05 1' 1.9 file'..,414-01/4 4 fl'-' 71:14, teyier,"11, License or Office of Consumer Affairs& registration valid for individual use only ..1.. . giMileSS Regulation HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 179682 Type: Office of Consumer Affairs and Business Regulation 1 10 Park Plaza-Suite 5170.:;!::''' : Expiration: 8/28/2418 LLC -.r.....,.-' Boston,MA 02116 THE TUCKER GROUP L1.0. THOMAS DADMUN 80 SCHOOL ST _ _ .. ....... HATFIELD,MA 01038 Undersecretary _ Not valid without signature ..... Massachusetts -Department of Public Safety Board of Building Regulations and Standards (umtrruo nun Sun irur License: CS-107019 THOMAS DADM N 60 SCHOOL STREET Hatfield MA O10 y .'17',,{,..,....&-tom• '; Expiration Commissioner 09124/2011 w _ ~ DADMUN Design + Construction Project Address: SubContractor List 7 Langworthy Rd August 8,2017 Northampton, MA 01060 Subcontractor: Has Employees: Yes No SMG Plumbing and Heating X James Elkins Electrician X Brian Po|an X SDL Home Improvement X Right Way Drywall X New England Granite X Cortina Tile X Dion and Sons Flooring X Executive Painting X A ® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 9/16/20].6 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 CONCONTACT Elizabeth Carballo Finck & Perras Insurance Agency Inc. {AICNNo.EXt): (413)527-5520 FAX (AID.No): (413)527^5970 6 Campus Lane ADDRIEss;bcarballo@finckandperras.com _INSURER(S)AFFORDING COVERAGE NAIC# Easthampton MA 01027 _ INSURERAArbella Insurance Group 17000 INSURED INSURER B: S M G Plumbing & Heating INSURER C: 133 Wyben Road INSURER D: INSURER E: Westfield MA 01085 INSURERF: COVERAGES CERTIFICATE NUMBER:CL1691602490 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE ,JNSD WVr1 POLICY NUMBER (MMIDD/YYYY) (MMIDoiyyry) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE X OCCUR DAMAGE TO RENTED 50,000 PREMISES(Es occurrence) $ 9520043009 9/4/2016 9/4/2017 MED EXP(Anyone person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE _ $ 2,000,000 X POLICY PRO- L JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURYPer accident) $ _ AUTOS AUTOS ( HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS _(Per accident) $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ _ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y I N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N I A (Mandatory in NII) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Proof of Coverage 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/B;TH .' "a` " _,AC.:, .. ieS, ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014!01) The ACORD name and logo are registered marks of ACORD 1NS025(2014013 CERTIFICATE OF LIABILITY INSURANCE DATE ACORD 17 � 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 NAME:NAME: Bresnahan Insurance Agency, In PHONE I Fax (413) 534-4291 IA/C., Ext): (413) 536-0536 ;(Arc No): 100 Whiting Farms Road EMAIL ADDRESS: Holyoke, MA 01040 1 INSURERS)AFFORDING COVERAGE NAIL _ INSURER A:Mapfre/Commerce Insurance Co. INSURED INSURER B: James Elkins INSURER C: 2 Williams Street �. INSURER 0 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 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 SUER` POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR AND POLICY NUMBER (MM/DD/YYYYY (MM/DDYYYY) LIMITS A GENERAL LIABILITY 8008030003716 5/5/17 5/5/18 EACH OCCURRENCE 1 $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PRTORENTED PREMI EMISES.0-- •. . $ „_100,000 CLAIMS-MADE t x OCCUR MED EXP(Arty ore pErscn) $ 5,000 PERSONAL&ADV INJURY $ GENERAL AGGREGATE ) $ 2,000,000 ,.., GEN'LAGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OPAGG $ 2,000_2_000PRO- X f POLICY I 1 .ECT LOC I �$ AUTOMOBILE LIABIUTY (EOMB1NEOSINGLELMR BODILY INJURY(Per person) $ ANY AUTO ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS _ AUTOS _JPraccident $ UMBRELLA LIAR OCCUR I EACH OCCURRENCE $_ EXCESS LIAB CLAIMS-MADE AGGREGATE �$ DED RETENTION$ _ $ YORKERS COMPENSATION WC STATU- 0TH- AND EMPLOYERS'LIABILITY Y/N TORY I WITS FR _ ANY PROPRIETOR/PARTNER/EXECUTIVE 7 N/A E.L.EACH ACG DE NT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE_-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS Below I E.L.DISEASE-POLICY LIMIT I $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is rewired) Electrician CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED W Dadmun Design & Construction ACCORDANCE WITH THE POLICY PROVISIONS. 60 School St. Hatfield, MA 01038 AUTHORIZE TATIVE 4z' %l j • ©1988-2010ACORD CORPORATION. All rights reserved. ACORD 25(201 0/05) The AC ORD name and logo are registered marks of ACORD Phnnp- Fw• C.hn-.fl. ----,n .._ ..,._. ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 4/3/2017 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 Cynthia Henderson, CISR Webber & Grinnell PHONE (413)586-0111 FAX (A/C.No.Extl: (A/C,No): (413)586-6481 8 North King Street E-MADDRIESS:chenderson@webberandgrinnell.com INSURER(S)AFFORDING COVERAGE NAIC# __ Northampton MA 01060 INsuRERA:Selective Ins Co of S Carolina —,----- INSURED INSURED INSURERB:SeleCtive Ins Co of Southeast 39926 SDL Home Improvement Contractors InC. INSURER C: 24 Chestnut Street INSURERD: INSURER E: Hatfield MA 01038 INSURER F: COVERAGES CERTIFICATE NUMBER Master 2017 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 SUBR POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY ' EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED A100,000 CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 52204065 2/1/2017 . 2/1/2018 MED EXP(Any one person) ' $ 10,000 PERSONAL&ADV INJURY j $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 X POLICY PRO- JECT I LOC PRODUCTS-COMP/OPAGG $ 3,000,000 OTHER: $ AUTOMOBILE LIABILITY Ea accdeDtSINGLE LIMIT $ 1,000,000 A ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED A9100328 2/1 AUTOS AUTOS /2017 ' 2/1/2018 BODILY INJURY(Per accident) $ X HIRED AUTOS ' X NON-OWNED PROPERTY DAMAGE AUTOS (Per accident) $ Underinsured motorist BI split $ 100,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB $ 1,000,000 DED X RETENTION$ 10,000 S2204065 2/1/2017 2/1/2018 $ WORKERS COMPENSATION X PER ' X OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER _ ANY PROPRIETOR/PARTNER/EXECUTIVE i Y I N/A E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? B (Mandatory in NH) WC9024456 1 2/23/2017 2/23/2018 E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The Workers Compensation policy does not include coverage for Paul Schmidt, Kendrick Dempsey and Douglas Schmidt. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE DADMUN Design + Construction THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 60 School Street ACCORDANCE WITH THE POLICY PROVISIONS. Hatfield, MA 01038 AUTHORIZED REPRESENTATIVE C Henderson, CISR/CIN '�044.o.lem•uaaz-- ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(7n14011 AW D CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 4/3/17 TRIS 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: Matthew Brown Dale A Frank Insurance Agency, PHONE Esti: (413) 665-8324 FAX (413) 665-1280 PO Box 455 (AIG No): Sunderland, MA 01375 ,ADDRESS: info@DaleFrankInsurance.com INSURERS)AFFORDING COVERAGE NAIC# INSURERA:Providence INSURED INSURER B:Progressive Rightway Drywall Inc. INSURER c:Guard Brian Johnson INSURER D: 206 Coles Meadow Road INSURERE: Northampton, MA 01060-1111 INSURERF: 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 ADDL SUBR POLICY EFF POLICY EXP -- LTR TYPE OF INSURANCE INSR WVD POU CYNUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A GENERAL LIABILITY BOP0093210 1/15/17 1/15/18 EACH OCCURRENCE $ 1,000,000 }{ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES(Ea occurrence) $ 50,000 CLAIMS-MADE OCCUR MED EXP(Any one person) $ 5,000 H PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATE LIMITAPPLIES PER PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PRO-£ � LOC $ B AUTOMOBILE LIABIUTY 02849700-1 1/26/17 1/26/18 (EOMBc Er)INGLELIMIT $ ANYAUTO BODILY INJURY(Per person) , $ ALL OWNED SCHEDULED - AUTOS AUTOS BODILYINJURY(Per accident) $ 500,000 NON-OWNPROPERTY DAMAGE HIRED AUTOS _ AUTOSED (Per accident) $ $ — UMBRELLA LIAB _OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ C WORKERS COMPENSATION R2WC815297 3/8/17 3/8/18 WC STATU- TORY EMPLOYERS'LIABILITY Y/N TORY I IMITS ER � CER/MEMBER EXCLUDER/ED? N/A ,OOO E.L.EACH ACCIDENT $ 10O (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICYLIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is requ red) 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 St Hatfield, MA 01038 AUTHORIZED REPRESENTATIVE I Matthew Brown © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The AC ORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 10/20/2016 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 Kasey Peters, Ext 103 Foley Insurance Group Inc. PHONE No.Ext): (413)214-7474 FAX No): (413)214-7447 37 Elm Street ADDRIess:kpeters@foleyinsurancegroup.com INSURER(S)AFFORDING COVERAGE NAIC# West Springfield MA 01089-2703 INSURERA:Patrons Mutual Insurance Co of CT 20028 INSURED INSURERB:Travelers Indemnity Co of CT 25682 __ ANDREY KORCHEVSKIY DBA New England Granite LLC INSURERC: ATTN: Andrey Korchevskiy INSURER D: 75 West School Street INSURERS: West Springfield MA 01089 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1 6102009434 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 SUBR POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE j X OCCUR DAMAGE TO RENTED 300,000 PREMISES(Ea occurrence) $ B0P2741752 5/23/2016 5/23/2017 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- LOC JECT PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) I ANY AUTO BODILY INJURY(Per person) $ ALL OWNED I ' SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS (Per accident) $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB i CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION _ AND EMPLOYERS'LIABILITY Y/N X STATUTE OTHER - AND ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? Y N/A B (Mandatory in NH) IEUB219M876716 10/22/2016 10/22/2017 E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 1 DESCRIPTION OF OPERATIONS/LOCATIONS/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/LYNNE <------- --- --- --A---..�� ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025 r2n14011 Client#:41601 CORTII ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 4/07/2017 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 Mary A. Henderson People's United Ins.Agency MA PHONE 413 781-6871 FAX (A/C,No,Ext): (A/C,No): 1391 Main Street, 3rd Floor ADDRESS: Mary.Henderson@peoples.com PO Box 4950 Springfield, MA 01101 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Merchants Mutual Insurance Co 23329 INSURED INSURER B: Cortina Tile of West Springfield 1645 Riverdale ST INSURER C W.Springfield, MA 01089 INSURER D 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. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER JMM/DD/YYYYL(MM/DD/YYYYL LIMITS A X COMMERCIAL GENERAL LIABILITY X BOPI071849 03/30/2017 03/30/2018 EACH OCCURRENCE $1,000,000 CLAIMS-MADE X OCCUR DAMAGE O(Ea RENTED $500,000 X Blkt Al Per Prior MED EXP(Any one person) $5,000 Written Contract PERSONAL&ADV INJURY $ GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY X JO ECT LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS (Per accident) A X UMBRELLA LIAB X OCCUR CUP9146566 03/30/2017 03/30/2018 EACH OCCURRENCE $1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $1,000,000 DED X RETENTION$10000 $ A WORKERS COMPENSATION WCAI033448 03/30/2017 03/30/2018 X PER OTH- AND EMPLOYERS'LIABILITY Y/NANY STATUTE ER OFFICER MEMBER EXCLUDED?ECUTIVE N N/A E.L.EACH ACCIDENT $500,000 (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 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 pkiwts chtlodx6kwic&A ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) 1 of 1 The ACORD name and logo are registered marks of ACORD #S812656/M795873 MADCT Acc ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 7/27/2017 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 Grynkiewicz Webber & Grinnell PHONE (413)586-0111 FAX (A/C,No.Extl: (A/C,No): (413)5B6-6461 8 North King Street ADDE-MRES AIL S: gmiewicz@webberandg b r krinnell.com INSURER(S)AFFORDING COVERAGE NAIC# Northampton MA 01060 INSURER A:Patrons Mutual Ins. Co. of CT INSURED INSURERB:State Auto Property & Casualty Ins. A. Dion & Son Floor Contractors, LLC INSURERC: Attn: Donald & Daren Dion INSURER D: P.O. BOX INSURER E: Hadley MA 01035 INSURER F: COVERAGES CERTIFICATE NUMBER:Exp 7/1/18 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 SUBR POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 A CLAIMS-MADE X OCCUR DAMAGE TO RENTED 300,000 PREMISES(Ea occurrence) $ BOP2806463 03 7/1/2017 7/1/2018 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 2,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 X POLICY X jE LOC PRODUCTS-COMP/OP AGG $ 4,000,000 OTHER: $ AUTOMOBILE LIABILITY EOMBcINdEEDtSINGLE LIMIT $ 1,000,000 A ANY AUTO BODILY INJURY(Per person) $ AALL OSVNED X AUTOSULED BAP2406132 03 7/1/2017 7/1/2018 BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS (Per accident) $ _ X 19 PIP-Basic $ 8,000 X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 2,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ CXS2125771 03 7/1/2017 7/1/2018 $ WORKERS COMPENSATION PER AND EMPLOYERS'LIABILITY Y/N X STATUTE X ORH- ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A B (Mandatory in NH) WCP2227689 03 7/1/2017 7/1/2018 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be 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, CIC, CISR/BK ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401) INGRAMJO01 MMILLS A RL CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 4/17/2017 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 The Jarrett Agency PHONE Melissa L Mills FAX 657 Enfield Street (A/C,No,Ext):(860)745-4222 (A/c,No): (860)741-6901 Enfield,CT 06082 ADDRESS:melissa@thejarrettagency.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Main Street America Assurance Company 29939 INSURED INSURER B:NGM Insurance Company 14788 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. INSR ADDL SUBR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF POLICY EXP (MM/DD/YYYY) (MMIDD/YYYY) LIMITS A COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR MPT7137P 08/22/2016 08/22/2017 DAMAGE TO RENTED X BOP PREMISES(Ea occurrence) $ 500,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- — — JE CT LOC PRODUCTS-COMP/OP AGG $ 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 (Per accident) $ _ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 B EXCESS LIAB CLAIMS-MADE CUT7137P 08/22/2016 08/22/2017 AGGREGATE $ 1,000,000 DED X RETENTION$ 10,000 $ WORKERS COMPENSATION I PER I 10TH AND EMPLOYERS'LIABILITY Y/N 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 $ DESCRIPTION OF OPERATIONS/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