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17C-019 (3) 96 NORTH MAPLE ST BP-2018-1146 GIS 9: COMMONWEALTH OF MASSACHUSETTS Mao:Block: 17C-019 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Categorv:ROOF BUILDING PERMIT Permit# BP-2018-1146 Project JS-2018-002065 Est.Cost: $3000.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: UseGrouo: SUNRUN INC 080034 Lot Size(sa. ft.): 18556.56 Owner: David Hill zoning: URB(1010)/ Applicant. SUNRUN INC AT: 96 NORTH MAPLE ST ApplicantAddress: Phone: Insurance: 734 FOREST ST STE 400 (9 8) 793-8584 WC MARLBOROMA01752 ISSUED ON:51412018 0:00:00 TO PERFORM THE FOLLOWING WORK:STRIP & SHINGLE ROOF POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occuoancv signature: FeeType: Date Paid: Amount: Building 5/4/20180:00:00 540.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner RECEIVED City of Northampton Slaws dPermit: Depwb"use only Budding Department Curb CuoOmeway Permit 212 Main Street Sewer/Septic Availabildy VAY - 2 2010 Room 100 Water/Well Availability mpton, MA 01060 Tvo Sets of Structural Plans or:Mstna+D e 4 7-1240 Fax 413-587-1272 PbVStie Plans NOF THAMPTOK NAMose Other Spedfy APPLICATION TO CONSTRUCT,ALTER REPAIR,RENOVATE OR DEMOLISH A ONE TO-7R�TWO FAMILY DWELLING SECTION 1-SITE INFORMATION (z �/ t� 1.1 ProosrbrAddraaa: his section to be cum~by office 96 N Maple Street Map 17C Lot 019 uret 001 Zoite Overlay Dlat W Ekn SL Dlsukt CB Dlaakt SECTION 2-PROPERTY OWNERSHNVAUrf WRIZED AGENT 2.1 Ow dRecord: David HIII 96 N Maple Street Northampton MA 01062 xeaegaeq Cu wtVIA%AEM1ess: (413) 923-8554 TabpNaie BlantWae 2.2 Aulhodad Mart Craig Orn 734 Forest Street, Suite 400, Marlborough, MA 01752 Nero 0" Cured Mgatd Address: 177- (978) 793-8584 S1~ Telephone c T item Estimated Cog(Dollars)to be ORidal Use Only cwApwted by pam"t W011011011 1 BUNK 3,000.00 (a)Budding Permit Fee 2. Ebstlical (b)Estimated Total Cost of Construction from 8 3. Plumbing Building Permit Fes 4. Medmnkal(HVAC) 5.Fire Pmledion 8. Total-(1 -2+3+4+5) 3.000.00 check Number a a/ 3qVI TAla Section For OBklel Use OnhF Budding Permit Number. Data Issued: r Signature: 3 Butlalnp d&adtpe Date U`^f Lc li(MIUW;�'tN2DkCt14N8 ' v� �'�* 4 JSY Section 4. ZONING Ali Information Must Be Completed.Permit Can Be Denied Due To incomplete MonnNion Existing Proposed Required by Toning This caunn b k fined in by BaWi�Dryutment Lot Sim Fmtoge Setbacks Front Side L:—R:— L:_R:_ Rear Building Height Bldg.Square Footage % Open Space Footage % il.a w mime Islas A,paved pariould N of Parlsing Spaces Fill: vaunec lasuioe A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO © DDNT KNOW ® YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO © DONT KNOW ® YES 0 IF YES: inter Book Page and/or Document M B. Does the site contain a brook,body of water or wetlands? NO Q DONT KNOW ® YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained Q , Date Issued: C. Do any signs exist on the property? YES ® NO IF YES,describe size,type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES © NO IF YES,describe size,type and location: E. Wal the construction activity distiab( nng,grading,excavation,or filling)over 1 acre a is it part of a common plan that will disturb over 1 am? YES NO Q IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK Icheck all applicable New Howe ❑ Addition ❑ 1 Replacement Windows Atieration(s) ❑ Rooting Or Doors ❑ Accessory Bldg. ❑ Demotitlon ❑ New Signs [En Decks f❑ Sitlhp R31 Other lq Brief Descnpem of Proposed Strip and re-roof. Alleration of s"tig hadmom_Yes_No Adding new bedroom Yes No Attached Nanatira Renovating unfinished basement !Yes NO Plena Attached Roe -Sheet tia. If New house and or addition to existing housina,Complete the f011oWina: a. Lite ofbuilding:One Famay Two Famiy Odwr b. Number of moms in each family unit Number of Bathroom; c. Is tirere a garage elfached7 d. Proposed Square footage of new construction. Dknmsions e. Number of stories? I. Method of healing? Fireplaces or Woodataea Number of each g. Energy Conservation Compliance. Masscheck Energy Canpliance form atachedl h. Type of oaatrucBan i. Is consbucaon within 103 h.ofmilands?_Yea _No. Is canstnrclion within 100 yr. floodpltln_Yea_No I. Depth of basement or cesar floor below finished grade k. Will Wilding conform to the Building and Zoning regulations? Yes`No. I. Sep*Tank_ City Sewer_ Private well_ City water Supply_ SECTION To-OWNER AUTHORIZATION-TO 13E COWPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERM t David Hill as Owner orgy subject IxoPany hereby authorize Sunrun / Craig Orn to act on my behatt,in all matters relative to work authorized by this buklmg permit application. sipiln orowwr DW I, Craig Orn as OwnedAulhoraed Agent hereby declare that the statements and information on the foregoing application arc true and accurate,to the bed of my knowledge and belief. Signed under the pains and penalties of perjury. Craig Orn Print Name ,e�— �J — 1 — I fi Svmuea Aiwa Da! SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor. Not ApppCable t3 Man,of tuansa Helder Craig Orn CS-080034 Lieu a Number 734 Forest Street Suite 400 Marlborough, MA 01752 01/22/2019 Address Fxukalbn Dae Sipatue Tekplwrc $.RMbtered Home hnmovement Contractor:. Not Appk" ❑ Sunrun 178937 Comma Name Re011ba0on Number 734 Forest Street, Suite 400, Marlborough, MA 01752 06/02/2018 Acidness Expiration Date TaNphotm (978) 549-9438 SECTION 10-VVORKERS'COMPENSATION INSURANCE AFFIDAVIT(LLO.L.c.162,126C(8)) Workers Compansadon Insurance al6tlevit must be co pleled and submitted with On apInbcallon.Failure to provide this aff d"will reautt in the deNY of the issuance of the WOW PUMB. Sorted Affidavit Attached VU....... R' No...... ❑ 11. - Home Owner Exemption The current exemption for"homeowners"we extended to include Owner-oeepded DweBion o(ons(I) m iwo(2)familia& and to allow such homeowner to engage an individual for hive who don not possess a license,provided that the swear sets at supervisor.CMR 780, Sixth Edition Section 108.35.1. Definition of Heme rte Person(s)who own a percd of land on which helshe redder or intends to reide,on which there is,or is intended to be,a one or two family dwelling,atewhed or detached structures acceoory W such use and/or farm atnscesre.AM son who combructs more than ons how in a tam-yeatam-ycar verled sba0 pet be eonaMered a knmeo Such"homeowmer"shall submit to the Building Official,on a Wim acceptable to the Building Officie4 skit kehhe shat be mmusible for all nth work perbrand!under the building permit As acting Construction Supervisor your Presentee on thejob site will be required from time to time,during and upon completion of the work for which this permit is issued. Also be advised that with reference W Chapter 152(Workers'Compensation) and Chapter 153(Liability of Employers W Employee Wr injuries not resulting in Death)of the Massachusetts General laws Annotated,You may be Ila bk for pesmn(s) you hire to perform work for you under this permit The undersigned"homeowner"certifies and assumes responsibility Wr compliance with the State Building Code,City of Northampton Ordinance,State and Local Zoning Laws and Sore ofMassabmeds General laws Annotated. Homeowner Signature City of Northampton 212 Main Street,Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A. Address of the work: 96 N Maple Street The debris will be transported by: Graham Waste Services, Inc. The debris will be received by: Building permit number: Name of Permit Applicant Craig Orn 5-- 1 - i i� C-=;, /, - Date Signature of Permit Applicant The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street, Suite 100 Boston,MA 02114-2017 www.mass.gop/dia Ulki,kers'Compensation Insurance Affidavit Builders/Contractors/Electricians/Plumbers. 'ED BE FILED WITII THE PERMI 11 ING AOTHORITI'. Applicant Information Please Print 1 bl Name (Business/OrganizatioWIndividual):Sunrun Address:775 Fiero Lane, Suite 200 City/State/Zip:San Luis Obispo, CA 93401 Phone # 978-549-9438 Are you an employer?Check the appropriate box. Type of project(required): 1.[ZI l Am a employer with.35 employees(full andsor part time)' 7. ❑New construction 2 I em a role pmpnetoror pannershiD end have no employees working council ❑any capacity-INu workers'comp.insurance required.] 8. E]Remodeling 30I am a M1omcowner doing al I work myself [No workea`comp.insurance required ' 9. ❑Demolition 4 n am a homeowner and wdl he hiringtractors to conduct all work on m ill 10 E]Building addition ensucon y properly I w re that an contramors either have wookers'compensation insurance or are sole IIf]Electrical repairs or additions proprietors with no employee.. 12.❑Plumbing repairs or additions 5❑l am a general contractor and l have hired the subconnaorors listed on the attached sheet 13.�ROOf repairs These subcontractors have employees and rest,workers comp_insurance.: 6.❑Wean,acoryoranow and its officers have exereped their right of exemption per MGL a 14.❑Other 152,§1(4),and we have no employees.Revelers may msumnce required_] 'Any applicant that checks box 41 must also fill out the sermon beluw showing their workers'compemation policy information. I Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. iCurnead irs that check this box must attached an additional sheet dowing the name of the sub wnoae res and state whether or not those entities have employers Ifthe sub-wntredors 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 alterability and job site information. Insurance Company Name Zurich American Insurance Company WC013696003&WC013696103 10/01/2018 Policy#or Self-ins. Lic.q.. Expiration Date:_ Job Site Address:96 N Maple Street City/State/Zip: Northampton MA 0106 —_ Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MCL c. 152,§25A ism criminal violation punishable by 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$250.00 a day against the violator. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby certify'under thepains and penalties o jury that the information provided above is true and correct. SSature: C Date: Phone#:978-793-85 Official use only. Do not write in this area,to be completed by city or town official. City or Town:_ Per. # Issuing Authority(circle one): 1. Board of IleaRh 2. Building Department 3.Cityll own Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: Massachu,.Aep,mmmtof PUWic$afexy consl Cron Sup ,Sor Board of Building Regulations area Standards Restdnetl to Unresmo;etl- 9c:ld:ngs pt a^.y se ggreep winch rpntam ticpnse:CSL$ggM less than 35 COO cubs feel C:4,1 cuMc meters)of C WiSiruC1YOP $pW NrST e%lo ( .a e CRAIG M ORR 73 WALNUT ST OXFORD NA 01510 FeWrn to poaepa.a Ganem edaun P,mn Meeaechpaette t:*nPrian: State ealkleg COMncansetarrrvoeatlondtAis lkemc. Commissionpfa� 011220019 UPS Licensing inigrmetion visp:WWW MASS.GOVIDPS k<erC:wW:YrtAiGinjpeYseu Rr6eHaee ME INPROVIall a.iaere or regyH»ion rely far lediNtlpaleu apfy GO1fIRACTOR befall 16e esPHMipn dple V fgmd retYrp eo: gtrae°g_AM, Typo: ORk<efCepixherAfiin pad Rpsfmna RpepMtion SUNRUNI PxA nda+s eta. Su9p%ioam0am FO Pero PMze.$aiH 51]0 NC. Itmmp,MA 02116 CRAIG ORN 595MARKETST?9TMFt, SAN f'RANCosco,CA 9tfa5 /yejid wHbpYt 4$parYn Contact Info: Sunrun Inc 734 Forest ST STE 400 Marlborough MA 01752 Tel:978-793-8584 Email:mapermitS@sunrun.com 1 y OATS 1.616 li 4 o CERTIFICATE OF LIABILITY INSURANCE I 9f11r2nl7 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 haitler is an ADDITIONAL INSURED,The unucybes)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 ce iflcata does net confer hts to the Certllkate hokfer in hBU of such endorsements. —1-1 PRODUCER NAME;_ Arthur J. Gallagher& Co. PHONE F,,,415-546-936o 415-536-8499 _ Insurance Brokers of CA. Inc License#0726293 _ �ets.NN>` — — £Yqx 1255 Battery Street 9450 San Francisco CA 94111 wsuNHRls AFFORDINGCOVEnq r,E J3!056 NcemsuRERn Zunch Annerrcan Insurance Cpm�an� R.,Isaias. SONRINC-01 VUKE B Naviaarms Special Ins _ Sunrun H eallatlon Services,Inc. a me _ —— 775 Fiero Lane,Suite 200 Ix.UReP- _ _. San Luis Obispo,CA93401 — "——— — — COV RA 5 CERTIFICATE NUMBER'926932564 REVISION N MBE THIS t5 TO CERTIFY THAT THE POI!CIES OF INSURANCE LISTER 6ELOW HAVE BEEN ISSOED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTVATHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONFRACT OR OTHER DOCUMENT\ATH 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 WSR — --A POLCYEW Yp-CT ESP inner. ON TYPE OF MBU RANCE POUCYNOMBER W W M DttYYY B X COMMERCIALGENER, UAROOTY Y TAPCOL2303211C 10/10017 ( 10/1/2018 EA01 DCCUNRErvcE 51 000,000 Sa fAGFTb RATES.... Ct IMS MdOE CXJOC4tRE M3BSE ut�A t!J— ElM ORa _ �JKOOOOMIDn _ MEn ExP lgr Prete) 39000 __ JJ AEk COAL a AGV NJV_RY 310OG 000__ GEN L AGGREGATE IJMIi EPLEPE S R GENERAL AGLREGAI E 52000000 —— O 4 �J 0. ��LCC RNOUOiO OOMWOFAGG ;2000000 J OTTONP.1 UWO E40,GOGOW A AU70MOML P OflIL E LIABILITY Y BAP915542504 10/1/2017 1011/201tl Ee ecclEanl a$OOO,OpO _ XJ ANYAUT6 00L1ILV x#A)RY G�fFbG' 4 E ��Dy��O f SGXEDVLLD I BOUIL INJUWY ryarad E n0 — gpyD60NlY I ALnOBVy' P )l cRiY GE IOTOo.1 ANTLL ONLY 8 UMBRELLA 4AA DCCUR EACH OCCURRENCE_ £FCEas OAe CLAIMSNAOE AGGREGATE_ E DED NEIEMION IF A ace"DrEELMER iies.4 Y4GGt 3696003 iNiY201] ;1XV2018 % STAHA OR A ANO HO"""'ERS"L1A60.rtT Y/N lNC013646403 tOlt l'I017 t0ti1201N ANYcE.AETOR/FARTNER/E%ECVTNE ❑q,I" EL.EACH gCL_IDFNi 51,000,000 QFFICERME as,EXCWUEb) £L DI REA56.EAEMR011 ft,000,000 _ IMamaWYM NMh _ IIy MMrvM M9e EL.nISEA$fPOLICY LIMB 51,000.00n OESCRIPiIOry OF GEERA710Nti haW,v -.- DESCRWi1ONOrCPERAikYISfLOCATKKi$IVENFLLS{ACORD 181,AEtlitlwai RerturMi S[haduk.mpY CeaeaaMtlamde apan la ev9Wred1 VVC013696003-$25,000 Deductible,WC013696103-FL, HI,MA,NJ,NY,OR,VA,WI only. Named Insureds: Sunrun Inc., Sunrun Installation Services Inc.,Sunrun South LLC,AEE Solar,Inc.,Clean Energy Experts LLC, Sunrun Solar Electrical Corporation Evidence of Insurance. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE city Of Northamplon THE EXPIRATION DATE THEREOF, NOTICE YELL SE DELIVERED IN 212 Main St ACCORDANCE WITH THE POLICY PROVISIONS, NonhampWn MA 01060 AsUT-NOR¢EDREPRESENTATYh ©19852015 ACORD CORPORATION. Ali rights reserved. ACORD 26(2016103) The ACORD name and logo are registered marks of ACORD coed CERTIFICATE OF LIABILITY INSURANCE1 7017 " 1/Uzo17 TMS-CERTIFICATE IS ISSUED AS A-MATTER OF INFORMATIONS ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, E(TEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTWICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S). AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: N N1a osrBOcate Ridder Is an ADDITIONAL INSURED,On Pollcy(iee)must be s ilarsod. N SUBROGATION M WANED,subject to the' and candidate of Be poky,caWn pukka may requb an sMonsnrm. A statement on this cxONcata does Not Onnfar it"to the wdNcN Irsldw In Ns of such• s rRlOarnM Ibrw12 Risk South Baatarn Insurance Group LLC Mas 77 Accord Park Drive Met- Unit Bl � pia Norwell Mgt 02061 ..0 erce Insurance C •clew •:Cram i Forster IndamnitY Graham Waste Services Inc J7nduramce Inscranw company 215 Chief Justice Cushing Hwy sea D: Cohmsset ma 02025 P• COVERAGES CERTWICATENUMBER:10-17 Ma.tar REVISION NUMBER: TMB O TO CERTIFY THAT THE POLICIES OF NNMAIDE UST S)BELOW HAVE KEN""TO THE INSURED NV ABOVE Flt THE POLICY PERIOD 11101CAlED. NOTWRIQTAMM ANY MO,LFOOE ,TEAM OR COlORp11 OF ANI CONTRACT OR OTHER DOCUMENT WITH Ry3AEC1 TO WHICH TRAM CERTIFICATE WY K OMXD OR WY PERTABA THE YIBINANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN O SUSAE TO ALL THE TERMS. E UBDra AND CONDITIONS OF BUGH POLICES.LBSTI,SHOWN WY HAVE BEE,REDUCED BY PAID CLAWS. TL TrIUSIM,IIRE Uan eeCIKllaaalY FrTlptct•clFxrl 10000 X UlsDpa OEldlalLWll1Y / 100 00 A tlAlrieSOE ®pan /01/2034 Tp1/20IY VlD EV 1 SOD PEa &AOraAew 1 10 Deeut!saw w 1 200000 ann AonEaRTE WfAW4lE PBk -c01PpP.Vo s Include x Muer u1c 1 AYIceOt[lLrIIRY 1 ,000,00 A "'Y'sno enOLr INAYpn Arm) i /LLQmEO X AutAm 2/31/2011 /11/2017 90CILr MARY Wr,/eYYy s X AV74i x AVIrr01 1 1 q3, % Iaesnuu2s OWUR eA0l accA.d9raA eswew nlyN,pE 17350 AOaEAAM X 10, 2/31/201e 2/31/3017 BYIMEy fAD1ACCFa2rNYA 0172152SA /27/2016 /27/2017 t Oa -U Lonu2!Mr YLAIC Marcos. Un1kralla 000233000 /31/2011 2/31/2017 Fa Ow�m"mrva. asi�roa of •1...'L04TpaelrnKlEa NYd,A00110w1.AYYlw.11lwba[IaAe.2awrnnr MrquYM) Mvidsna of Inrurarlco CERTIFICATE HOLDER CANCELLATION SHOULDANY IOTHEAYS THEREOF. NOTICE W11CANCELLEDKFORE THE IXMATDN PATE gERlOF, IDMS RILL Be KLWlRED W Sunrun Inc. ACCORDaDl W1111TK POKY PROV140N8. 738 Forest Street, Suite 400 A0r1aRDM0INMNEmAIIVE Marlborough, IIA 01752 John %ow"1/0IVE - ACORD 25(2010105) O 19853010 ACORD CORPORATION. AN rights n mr," '15025(sweats, The ACORD name and logo n registered marks of ACORD AcoR& CERTIFICATE OF LIABILITY INSURANCE Is.. / 04/30/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed, If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such erah rstimart(s). PRODUCER CONTACT P ISABELE CORDEIRO Brazway Insurance PHONE E.I.978-055-5991 _ _ aAc N.1:978-455-9934 345 Main St Unit B7 E."CIL Tewksbury MA 01876 AODREss,-info@brazwayinsuranceagency.com SUNABSIAFFOROIMG COVE RAGE XglCp _ SURER A:ATLANTIC CASUALTY INSURED INSURER B:COMMERCE INSURANCE TECHNOLOGY ROOFING DESIGNS INC -- 969 WESTFORD ST SURERc.NAUTILUS INSURANCE INSURER D.AIM MUTUAL LOWELL MA 01851 - - INSURER E NSURER 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. IN50. ADOL aUBN POLICY EFi POLICY EXP ITS TYPE°F INSURANCE POLICY HUMBER NOOMYY WDOYSA LIMRN TEDMERCIAELIABILRYEACHOCCVRRENCE $1,000,000 CLAMSAADE NERAL OGLVR pDA REMI5E5�Ea� s100x000 EDEXPLA�nI $5,000A _ _ L717002782 03106/2018 0310612019 PERSONAL a ADVINUORY $ 1,000,000 GEN L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGJTE $2,000,000 JOUST❑PECT ❑LOC PRo°ucTs.comprop AGG s2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMMINEDBROLEIIMIT $ 1,000,000 Ee a_M _ qNV ALTO BODILY INJURY IPerpermn 3 B OWNED SAOTEDULEO GRM759 0411112018 04/11/2019 BODILY INJURY IPS—deoe s AUTOM ONLV Os HIS. NON-EWNED pHOP RTY OAAIAGE AUTOS Orva ACLOG ONLY eemL _ s UMBRELLA LIAR OCCUR EACH OCCURRENCE $3,000,000 C EXCESS Lieu CLAIM&MAGE AN037249 0310612018 03/06/2019 AGGREGATE $3,000,000 OED RETENTIONs s WERNERS COMPENSATIONPER CHIP ...MPLOYERS'LIABILITY YIX STATUTE ER m NROPRIETOPPARTNEwExECUTIVE - F.L.EACH ACCIDENT g 1,000,000 D OFFICENMEMBEREXCLUDEO, O NOW IManmmrpm AHl AWC40070345642017A 06/22/2017 06/2212018 EL.DISEASE-EAEMPIAYEES 1,000,000 IOEsc'TIESo OPERATIONS meow EL O�iSEASE.POLICY Limn '1,000,000 LiH Elm DESCRIPTION OF OPERATIONS I LOCATIONS r VEHICLESLACORD IS! Adanluml Remarks SESSAMI,,mry be Madman is rem MG.I.ommessl PAINTING,CARPENTRY,SIDING AND ROOFING SERVICES 2002 DODGE RAM 1500 VIN:3D7HA18N82G149590 CERTIFICATE HOLDER CANCELLATION SUNRUN INSTALLATION SERVICE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 734 FOREST ST SUITE 400 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN MARLBOROUGH,MA,01752 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOR¢E°REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All Tights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD PrMMom Msme Fwme Boss web Some— voess,G msaoseeom lq Impressive Pubranmg 800R08.I977