32C-020 (5) 21 PLEASANT ST-APMTI BP-2018-1374
GIS#: COMMONWEALTH OF MASSACHUSETTS
MV:Block:32C-020 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL 042A)
Cateeorv:renovation BUILDING PERMIT
Permit# BP-2018-1374
Project# JS-2018-002434
Est.Cost: $40504.00
Fee: $287.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: WRIGHT BUILDERS 106505
Lot Size(sa.ft.): 4225.32 Owner. BLUMENTHAL BARBARA&!OE
zoning:CB(100Applicant: WRIGHT BUILDERS
AT. 21 PLEASANT ST -APMT 1
ApplicantAddress: Phone: Insurance:
48 Bates St (413) 586-8287(116) Workers Compensation
NORTHAMPTONMA01060 ISSUED ON:6/21/2018 0.00:00
TO PERFORM THE FOLLOWING WORK RENOVATIONS TO APMT - NO STRUCTUAL -
REMOVE SM LIFT FROM STORE BELOW TO STORAGE AREA ABOVE, INFILL FLOOR FRAMING
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 6/22/20180:00:00 $287.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
File k BP-2018-1374
APPLICANT/CONTACT PERSON WRIGHT BUILDERS
ADDRESS/PHONE 48 Bates St NORTHAMPTON (413)586-8287(116)
PROPERTY LOCATION 21 PLEASANT Sl -APMT 1
MAP 32C PARCEL 020 001 ZONE CB!I(ice/
THIS SEC:"'[ON FOR OFFICIAL USE ONLY:
PERMI P APPLICATION CHECKLIST
OSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
TweofConstruction: RENOVATIONS TO APMT--NOSTRUCTUAL-REMOVE SM LIFT FROM STORE
BELOW TO STORAGE AREA ABOVE,INFILL FLOOR FRAMING
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included'
Owner/Statement or License 106505
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
Approved Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND/OR Special Permit With Site Plan
Major Project: Site Plan AND/OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §�
Finding Special Permit Variance'
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Cub 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
D olition Delay ///
Si of Buidit al Da� / LS�
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.
i
Versionl.7 Commercial Building Permit Ma 15,2000
Department use only
RECEIVED ity of Northampton Status of Permit
wilding Department Cum CutfDNvaxayPermit
212 Main Street Sewer/Septio AvallaUllBy
JUN 21 2018 Room 100 Waternven Avallat Ky
No ha on, MA 01060 Two Sets of Structural Plans
in 413- 87-1240 Fax 413-587-1272 Plot/Site Plana
DFPT OF BUILDING INSPECTION$ Other Spi
wwo
RUCT,REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING
OTHER THAN A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
1.1 Properly Address: This section to be completed by office,Map '�ar'r G Lot D aO Unit
YLG IC> T Zone Overlay District
Elm SL District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
-,-bSTlH- &A) (091J�pti � Pcensawr S�; IN`0 "Pto �
Name(Print) Curren Mailing Address:
F ( � u +d,� Iia -9;16 - 6
Signature Telephone
2.2 Authori d Agent:
Name(Print) Current Mailing Address:
Signature "" 1 Telephone .L,�
SECTION 3-ESTIMATED CONSTRUCTION COSTS 7 Y �a �(k. pp
Item Estimated Cost(Dollars)to be Official Use Only
co m leted b ermit applicant
1. Building 9 '; .ter, (a)Building Permit Fee
2. Electrical �. 'I O (b)Estimated Total Cost of
7 Construction from 6
3. Plumbing .�I �. �. Building Permit Fee
4. Mechanical(Hi -/�1 f/' a�j /
5. Fire Protection
6, Total=(1 +2+3+4+5) Or SC /' Check Number K5 a
This Section For Official Use Only
Building Permit Number Date
Issued
Signature:
Building Commissionerllnspactor of Buildings Date
Versionl.7 Commercial Building Permit May 15,2000
SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
CUBIC FEET OF ENCLOSED SPACE
Interior Alterations )��I Existing Wall Signs ❑ Demolition El Repairs El Additions El Accessory Building El
Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing Change of Use❑ Other❑
Brief Description Enter a brief description here. 06VA N S to T li S•�.�'ed-CT PAI—
Of Proposed Work: �
�Y16 tM, Lq ill
-,,VW ID 01��'(r�,r/srR •' A/MYr
SECTION 5-USE GROUP AND CONSTRUCTION TYPE it -•p Qom' i % Ili W. 1- u'
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly ElElElA-2 ElA-3El -TW 1A ❑
A4 ❑ A-5 ❑ B ❑
B Business ❑ 2A ❑
E Educational ❑ 28 ❑
F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑
H High Hazard ❑ 3A ❑
I Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 3B ❑
M Mercantile ❑ 4 ❑
R Residential R-1 ❑ R-2 R-3 ❑ 5A ❑
S Storage ❑ S-1 ❑ S-2 ❑ 5B
U Utility ❑ Specify:
M Mixed Use ❑ Specify:
S Special Use ❑ Specify:
COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE
Existing Use Group: Proposed Use Group: Nd G11.Ad`I
Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34):
SECTION 6 BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY
1T06
Floor Area per Floor(sf) N b � 9
1` V,
2nd Zoe
P 3i°
4� q'°
Total Area(so Total Proposed New Construction(sf)
Total Haight(it)
Total Height 0
7.Wa r Supply(M.G.L.c.40,§64) 7.1 Flood Zone Information: 7.3 Sewag isposaI System:
Public Private ❑ Zone Outside Flood Zona Municipa On site disposal system❑
k"t, New wbpr- -T. ec bb Nig wi-Wd t tsh�'v Fe�reh'r'�
VersionlJ Commercial Building Permit May 15,2000 (r-
8. NORTHAMPTON ZONING
Existing Proposed Required by Zo
Thisuito lee m M
T!!7
ent
Lot Site
Fron e
Setbacks Front
Side L: R:- R:
Rear
Building Height
Bldg,Square Footage
Open Space Footage
(tur area minus bldg&pay
arkin
N of Parkin S ces
FiIP
me ffi t.acation
A. Hasa Special Perm it/Van ance/Findin ever been issued for/on the site?
NO () DONT K14OR YES O
IF YES, date issued:
IF YES Was the permit recorded at the Fdegistry of Deeds?
NO O DONT MM O YES O
IF YES enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO 1� DONT <NM O Y6 O
IF YES, base 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 Y6, describe size, type and location:
D. Are there any proposed changes to or additionsof signs intended for the property ? YES O NO
IF YES, describe size, type and location:
E. Will the construction activity disturb(clearing,grading,ex vatton,or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES O NO 'Q
IF YES,then a Northampton Sto rn Water Management Permit from the DPW is required.
Vcrsioni.7 Commcrcial Building Permit May 15,2000
SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO
CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116(CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED SPACE)
9.1 Registered Architect:
Not Applicable ❑
Name(Registrant)
Registration Number
Address
Expiration Date
Signature Telephone
9.2 Registered Professional Engineer(s):
Name Area of Responsibility
Address Reg io al Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Data
9.3 GeneralContractor
Wi, , k + �) — ✓r t — Not Applicable ❑
Company Name:
Responsible In Change of Construction
i AA Sr, N op— N-i tgJ' AA k
Address,.
l AVO L4W0Aw�
Signature Telephone
Versuni Commcrcial Building permit May 15,2000
SECTION 10.STRUCTURAL PEER REVIEW(760 CMR 110.11)
Independent Structural Engineering Structural Peer Review Required yes O No
SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED ---
OWNERS AGENT OR CONTRACTOR
RAAPPLIES
� F,OOR, BUILDING PERMIT
I, '� V G J 1'U(VM%9'11�.,{�`�Q '� as Owner of the subject property
hereby authorize (Ph "G t (' J� to
on gly beW,in all matt lativ work auth z y this building permit application.
Signature o er Date
as Own Authorized
gen ereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge
lief.
Signed under the pains and penalties of perjury.
weu
ALX I I\ t'4Lti�\ A
Signature of C*h1adAgi Data
SECTION 12-CONSTRUCTION SERVICES
101 Licensed Construction Supervisor: qpy .A �(/�/ 1 .,y� Not Applicable El
Name of License Holder WH
X I I!1 �1 rA l ('V lieui ' 0
License Num" /' I
Address Expiration Date
SignaWre Telephone
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.C.162,Q 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 No O
WRIGHT
BUILDERS
June 21, 2018
Louis Hasbrouck
Building Commissioner
City of Northampton
212 Main Street
Northampton, MA 01060
RE: Building Permit for:
Renovations to Apt#1 (above Downtown Sounds)
21 Pleasant Street
Northampton, MA 01060
Dear Louis,
We respectfully request that you grant a Building Code modification to waive the
requirement for control construction for the small renovation work at 21 Pleasant St,
Apt#1 (scope of work attached) because the work is of a minor nature,will not affect
health, accessibility, life and fire safety, or structural requirements and is impractical in
that the cost of control construction is considerable when compared to the cost of the
proposed work. Thank you for your consideration.
Please let us know if you have any questions or need additional information.
Sincerely,
L hdOL 4U4►-e, -
Linda Gaudreau
Operations Manager
NEW HOMES+WORKPLACES+DESIGN+RENOVATIONS+ENERGYRETROFITS+CONSTRUCTION MANAGEMENT
48 Bates Street, Northampton,MA 01060/413.586.8287/Fax 413.587.9276/www.wright-builders.com
Downtown Sounds Scope of Work
21 Pleasant Street,Northampton, MA 01060
May 31n`,2018
General Conditions
o Northampton Building Permit and all related trades'permit fees.
❑ Parking Meter Bag Fee.
o Dumpster for removal of existing flooring,plumbing fixtures,cabinets/counters,miscellaneous lumber,
etc.
o WBI Supervision,General labor,and Carpentry.
o Temporary sani-can for duration of work.
in Protective Material(floorin&dust shield,etc.).
Cleaning
❑ Final Cleaning: Floors, walls,windows,cabs/counters,plumbing fixtures.
Wood&Plastics
o Demo/Frame/Finish labor.
❑ Demo existing lift,infill floor framing,patch finishes on both 2'and 2n'floors.
o Demo all tack-boards,shelving,PVC racks,etc.—'gutting'both the 2n°and P floors.
o Remove existing Kitchen and Bath Cabinets and Counters.
❑ Remove existing Kitchen and Bath floors.
o Install running and standing interior trims to match,as needed—all floors.
Doors&Hardware
❑ Install new flush panel,solid core door w/keyed lock to apartment Mechanical Area.
(accessed from 3r°floor).
Finishes
o Drywall patching,as needed,including area of lift removal.
❑ Repairs—tooth in wood flooring at 2n°floor,as needed,with 2 Y."red oak,sand and finish with one coat
of Loba Intensive Oil and three coats of Loba Water Based Floor Finish.
❑ Install new Vinyl Plank Flooring,material allowance of$3.50 sgft.,in Kitchen and Bathroom areas.
Removal of existing underiayment and installation of new underlayment included.
❑ Install new Carpet,material allowance of$3.00 sgft.,at Stairs,Landing,and 3'a Floor Living Space. This
includes closet areas.
o Paint all walls,ceilings,and trims. Cut all trims,including rails/balusters,and spray the walls/ceilings.
Appliances
o All appliances are supplied by owner,installed by WBI.
Furnishings
c Bathroom: Medallion Cabinetry,Gold-Line,all-plywood construction, Potters Mill doorstyle(flat center
panel for painted products),maple wood species,in a standard paint option(see Images).
ri 21'Deep,32"Tall,30'Wide Vanity.
o Countertop is for Stone Creations' Premium Quartz Series Option. Incudes 4" backsplash and sidesplash
and white oval bowl and standard edge option. (31'x 22 H').
o Kitchen: Medallion Cabinetry,all-plywood construction,Potters Mill doorstyle(flat center panel for
painted products)in a maple wood species in a standard painted option. Stove area and peninsula.
(see images).
❑ Countertops are Classic Series Quartz Options.
Plumbing
❑ Kitchen: Sink is under allowance—product TED. Install(1)new single-hole faucet.
(See cut sheets for more).
❑ Bathroom:
• Install(1)single-hole faucet(vanity/countertop/integral sink by others).
• Install(1)multi-piece tub/shower unit.
• Install tube/shower valve and trim.
• Install(1)toilet—move the toilet Flange over approximately 2"—3"so it is centered between the tub
and the vanity,and at least 15"to center from the edge of the tub and vanity.
• All new fixture stops,traps,supply tubes,and miscellaneous parts needed to connect the new
fixtures in similar locations to where they currently exist.
(See cut sheets for more).
HVAC
o Existing system to remain. WBI to paint existing baseboard covers.
Electrical
❑ Disconnect, remove,and relocate wiring for lift.
o Add(2)20amp circuits with GFI's(Kitchen—as per code).
❑ Replace all outlets,switches,plates.
❑ Install owner-supplied fixtures with bulbs.
o Supply and Install(2)smoke/CO2 detectors with battery back-up.
❑ Existing heat/hot water to remain.
Lighting
❑ Decorative Lighting(fixtures)supplied by owner,installed by WBI.
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: 2 I >°f�H SA !Ji sTt -,
The debris will be transported by: w H f}fj- "L"bE`i?---f
The debris will be received by: VAu. IJ c1,I
Building permit number:
Name of Permit Applicant A-,r-jN
4R
Date Signature of Permit Applicant
�\ The Commonwealth of Massachusetts
Department of IndustrialAccidents
I Congress Street,Suite 100
Boston,MA 02114-2017
www.n issgov/dia
VII.rivers'Compecriation Insurance AtBdarit:Builders/ContraMors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant 1 f tia^ / Please Print Leeibly
Nature(Businass/Ofganiratioodkdivall �r ' v rfT A- "eq-]O
Address: R s
City/state/zip: NoNMMH (off, MkOtOW Phone#:/'41-?—
Are you an employer?Cbeok rbeapproPrhn box: Type of project(required):
I_E]I am a employer with _employers(full and/or parlfimc).• 7, ❑New construction
2.❑lemesole proprietor or pannershipand have no employees working formein
.
' $ Remodeling
aycapmany [Nowokerscompnsumnce re,tansil 9. Demolition
J❑IamahomeownerdoegatIIworkmyseIf INoworkers'compnvrancenquired '
4 I am a Immamener and will be hand,commuters m conduct all work on my propertywill
1 wi10 Building addition
ensure that all wntreatms either have workerscompensation tro mme or are sole 11.❑Electrical repairs or additions
��-��- n/////�����prop^erors with no employees. 12.E]Plumbing repairs or additions
Sf]9#am a general contractor and l have hired the sub-conmadins listed on the asached sheet 13.E]ROOfrepairs
Thesesub-commctors have employees and have workers'compinsurance I
6,F-1 We are a comatlon and its omecrs have exercised ricer debt of exemption per MGL a 14.❑Other
152,§I(4),and we have no employees.[No wode b comp insurance required.I
*Any applicant that checks box 4I mast else fill out the section below showing their workers'cumpemalems policy information.
I Homeowners who submit Nis amdavo indicating they are doing all work and than hire outside contactors must submit a new affidavit indicating such.
1Contmetors that check Nis box most attached an additional sheet showing the name of the sub-cenlactors and slate whether or not hose entities have
employees. If the sub-convectors have employees,they most provide their workers'comppolicy number.
I am an employer that is providing workers'compensation insurancefor M employees Below is the policy and job she
information.
Insurance Company Name: l� --yt�. r�
Policy#or Self-ins.Lic.#: M GC p w0a'00D 7;5 n-i,,1 a A Expiration Date: 71
I I
Job Site Address: a') Pl. /1'sn-r�,'srr �l City/State/Lip:jib�W P�hfr M�
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). 0
Failure to secure coverage as required under MGL a 152,§25A is a criminal violation punishable by a fine up W$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 inaumanec
coverage verification.
I do hereby c d �/Edder t epai ss and penalties of perjury that the information provided above is true and correct.
Sign t /l� 11 II )�,ArryC�'A Date (1l tl\�
ph #� I'Lf R— S E10— 7
Official use only. Do net write In this area,to be completed by city or town oJrcial
City or Town: Permit/License k
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.CityrFown Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone 4:
ACi CERTIFICATE OF LIABILITY INSURANCE DA03122izo1�e n
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,EMEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE ACONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER
IMPORTANT. If the certHlCate holder Is an ADDITIONAL INSURED,the pollcy(les)..at have ADDITIONAL INSURED paslSlons or be endorsed.
If SUBROGATION IS WAIVED,subject to the terms and conditions of the Policy,cer sim policies may require an endorsement. A statement on
this ceHlficate does not confer rights to the Certificate holder In Ilan of such andomement(s).
PRODUCER r1 ons Jenna Roddgue,CISR Elite
Webber B Grinnell PlroeME
E , (413)58&0111 Ax Na: (413)506-6081
8 N.0King Street El King Imdhgue@webberandgdnnell.com
INSUMRISI/1FTOMINGCOWMGE XNc•
NOnhah,ol MA 01060 IXSURERA: Arbella Insurance Group 17000
INSURED INSORERe: Al Mutual
Wright BUIIdi IIIc INSURERC:
Atth Jonathan Wright INSUMRD:
46 Bates Street INSURER E:
NOrtherl MA 01060 INSURER F:
COVERAGES CERTIFICATE NUMBER: Master 2019 REVISION NUMBER:
THIS IS TO CERTIFY THATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING MY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR TWE OF INSURANCE POLICY NUMBER a CYEFf YN EV LIMITS
COMMERCIALGENEMLLMIUTY EACH OCCURRENCE 5 1.000,000
CLAIM3MADE OOCCIIR PREMISES(Fe aavmn® $ tOO'OOO
MED EXI lArl.1) 5 5.000
A 850DOM266 0310112018 031012019 PERAONALAAGn INJURY 5 1.000,000
GEN LAGGREGATE LIMITAPPLIES PER GENERALAGOREGATE 5 2.000.00
X POLICY JEVR W
LOC PROCTB.COMPIOPAGG 5 2'000.000
OTHER: Employee Benefits 5 1,000.000
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 5 1000,000
Ee..I
ANYAUTO BODILY INJURY IPe,beel 5
A MINED SCHEDULED 1020070845 OW01/2018 031010019 BODILY INJURY(Per worl 5
AUTDBDNLY X euros
HIRED NON.OWNEO IF—II DMWGE $
X AUTDSONLY X Aul ONI Pel—No
PIP-Basic S 8,000
UMBRELLA LUNG X OCCUR EACH OCCURRENCE 5 5'000,000
A E[CEB.LMB GIAIMsL ADE 4600068256 03/O1n019 031010019 AGGREGATE $ 5.000,00
OED I RETENTION S 10000 5
W ERS COMPENSATION
EMPLOYERS'LABILITYYIN X STATUTE ER
ANY PROPRIETOO N/A MGG2OO2000$342O16A O3I012018 031012019
RIPARTNERADOCUTIVE EL MCHACCIDENT 5 500,000
B OFFICENMEMBER EXCLUDED?
tEry In NH) EL DISEASE-EAEMPLOYEE $ 500,000
MenM
IoeSCIRPTlonOF PERAHONS below EL DISEASE.POLICY LIMIT $ 1,0001000
DEWRIP)MIN OF OPERATIONS I LOMTIMSI VEHICLES ACOM 1%,AYCltlone N,Ix,Ye SG,eOUM,mry M eWaMp H mon spew b,quln4l
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
Informational Purposes Only ACCORDANCE Mol THE POLICY PROVISIONS.
AUTHORDEO REPMSENTATIVE
bt_
019BB-2015 ACORD CORPORATION. All rights nseread.
ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
Commonwealth of Massachusetts
Dwision of Professional Licensure
floard of Building Regulations and standards
Con str4fChbn'SOPgrvlsor
CS-106505 N Ellpires: 1110112018
AHA MoOSCAIE
237 WEST HApyEY
CHI1Rl.EMON(MA 11
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tnrasbNYed-BUM Construction Supervisor
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Office of Consumer affairs and Business Regulation
10 Park Plaza- Suite 5170
Boston,Massacbiwtts 02116
Home Improvement Registration
ROOietrdtrr 101638
Tyw PdvWA CarywOBon
EmkMIwL' GM=8 TN 410701
WRIGHT BUILDERS, INC.
Jonsihan Wright_
46 BATES STREET
Northampton, MA MOO u0am Addrs eed emri era.Markruro.8v a.ep,;
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