32C-201 (5) 89 WILLIAMS ST BP-2019-0121
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map-.Block:32C-201 CITY OF NORTHAMPTON
Lot-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit- Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category,REPAIR BUILDING PERMIT
Permit# BP-2019-0121
Project JS-2019-000199
Est Cost$9730.00
Fee $63.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: PRO-TECH WATERPROOFING SOLUTIONS INC 095913
Lot Sizc(su ft.), 3789.72 Owner: LAMONDE KIRSTIN UNGER&JASON E LAMONDE
zoning,URC(100)/ Applicant.• PRO-TECH WATERPROOFING SOLUTIONS INC
AT: 89 WILLIAMS ST
Applicant Address: Phone: Insurance:
864 MONTGOMERY (413) 533-8217 WC
CHCOPEEMA01013 ISSUED ON.7/31/2018 0:00:00
TO PERFORM THE FOLLOWING WORK:BOWING IN OF NORTHSIDE FOUNDATION AT
STAIRWAY
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:
FeeTvoe• Date Paid: Amount:
Building 7/312018 0:00:00 $63.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2019-0121
APPLICANT/CONTACT PERSON PRO-TECH WATERPROOFING SOLUTIONS INC _
ADDRESS/PHONE 864 MONTGOMERY CHICOPEE (413)533-8217
PROPERTY LOCATION 89 WILLIAMS ST
MAP 32C,PARCEL 201 29 ZONE URC(100
TJJ[S SECTIO3V COR OPFICiAL USE ONLY
PERMIT APPLICATION CHECKLIST
CLOSED REQUIRED DATE
ZONING FORM FILLED OU
Fee Paid
airdm 'ermit Filled q
Fee Paid
>ypeofCnnstruction: BOWING IN FNO FQUNDATION AT STAIRWAY
New Construction
Non StruU'ura(interior renovations
Addition tp Existinu
Accessory Structure
Buitdine Pians Included:
Owner/Statement or License Q95 UI
3 sets of Pians/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO ATION 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 Pian AND/OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER:§
Funding Special Permit Variance'
Received&Recorded at Registry of Deeds Proof Enclosed
_Other Permits Required:
,Curls Cut&om 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
F�
tgna afB. d. iai Date
Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all inning
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.
&EIVEL _.
W4 �--�� ! Qepartmant acts oMy
City of Northam ton Status of Permg:
[}@part nt Curb CdfOrNeway Pemat
4- phone
OFBUmvIN!'," 2)31a7114St t Sewer/Sapac AvailabilityRin
waterlwall Avaaa editsNorthampton, MA 01080 Two Sets of SWctural Plans
413587-1240 Fax 413-587-1272 Flutists Plans
Other Specify
APPLICATION TO CONSTRUCT,ALTER REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION i-SITE INFORMATION —_1
1.1 ProuertY Address: This section W be completed by office
$9(�.�jJpill,atnS5# Map 3:t Let t9-t)/ unit
4(+t)CU It�'�n, IN OIGl u zone -O1reHay District
_ Elm Se Dirbict _ Ca Diemat
SECTION 2,PROPERTY OWNERSHIPtAUTHORYLED AGENT +�^
2.1 owner of Record:
Ir '1 a��bn le 41 co,*evine SADrGr ion, VT
Nam t) COMWMA
Y
Telep,hoh.ne
2.2 Authoread Anent:
Nams,(PMO Covent Mailing Address:
ei9neture -- Talephore ..
SECTION 3,ESTIMATED CONST WMON COSTS
item Estimated rust(DOM)to be Official Use Only
cum,feted by permit applicant _
1. Building (a)Building Permit Fee
2 Electrical i (b)Estimated Total Coal of
Consyuctlon from S _
3. Plumbing Building Permit Fee
k Mechanical(HVAC)
5_Flm Pmtaction tJVVrrr
6, T3Ut=(1 +213+4+5) --... Gixdc Number
._ This Section For Official Use OnIY _
Building Peemd NumberDate. — Issued:
Signature
eu'�M'mg ionerthxpecta of aWkNtgs Dais
f?2�fiT_,eeh 4uct�er'�t�o�r�5nlu�nras ��ma.�.�. Cem
EMAIL ADDRESS(REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
Section 4. ZONING All Information Must Be Completed.Permit can Be Denied Due To Incomptete Information
Existing Proposed Required by Zoning
Ibis column to be filled in by
Building DWarhauit
Lot Si.
Frontage
Setbacks Front
Side U R: U R:-
Rear
Building Height
Bldg.Square Footage %
Open Space Footage %
(Lot arca minus bldg&pavM
erki
N of Parking Spaces
Fill:
volume&Location
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO Q DONT KNOW O YES Q
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO O DONT KNOW O YES O
IF YES: enter Book Page and/or Document H
B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW O YES O
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained O Obtained O , Date Issued:
C. Do any signs exist on the property? YES O NO O
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES O NO O
IF YES, describe size, type and location:
E. Will the construction activity disturb(clearing,grading,excavation,or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES O NO O
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
SECTION 5-DESCRIPTION OF PROP05ED WORK tchack all applicable)
New House ❑ Addition ❑ Replacement Windows Atteration(s) Roofing
Or Doors ❑
Accessory Bldg. ❑ Demolition ❑ New Signs [01 Decks [❑ Siding(❑) Other[a
Brief Description of Proposed
Work:
Alteration of existing bedroom_Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
ea.If New house and or addition to existing housing, complete the following:
a. Use of building:One Family Two Family Other
It. Number of rooms in each family unit: Number of Bathrooms
c. Is there a garage attached?
d. Proposed Square footage of new construction. Dimensions
a. 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 fl.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
I, ,as Owner of the subject
property
hereby authorize
to act on my behalf,in all matters relative to work authorized by this building permit application.
Signature M Owner Date
I, rl as OwnedAuthommd
Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge
and belief.
Si¢¢n.,ed under the pains and penalties of perjury.
l Sf, L naAnr-
Pri�n/t���i�i��me /� Qt,/ r' per. @ +} p
h. /i 1� iyQ XU X40-ft�.a-
Signature&OwnedAgtsm I Date
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed LiCon truction Su miser: Not Applicable 0 2
Name of nney Nolder: II I �t a 2,591
-0 ,5 1✓
q License Number
gro4 NTDn��meM � � ico�ez MA o (el3
Add.. CA-LL E>iimdon Date
sigma Telephone �
9.4"kUlpid
m. Not Applicable ❑
fa eeh W33S
Comoa, Ware Registration Number
8' o Muco � D/ i3 R/aoig
Address �/ Expiration Date
Telephone 13-533-94X7
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.151,§15C(8))
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 peril.
Signed Affidavit Attached Yes....... No...... ❑
�\ The Commonwealth ofMassachusefts
Department offndustrialAccidents
I Congress Street,Suite 100
Boston,MA 0211 4-2 01 7
www.mass.gov/dia
gbrkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information Please Print Legilil
Name(Business/OrganintioNlndividual): fb' c( '361ELLAS (I
Address: M &Jaonel
City/State/Zip: C 0I0I3 Phone#: y 133-�533-g,)-1
Are you an employer?Check the appropriate box: Type of project(required):
I.jg I mu a employer with employees]full nnNmpmt-time).' T 1]New construction
2❑lama sole proprieram patetwahip arta have no employes working forme in S, ❑Remodeling
any capacity.[No workers'comp.ins.n Irynhed.l
3.11 em a homawner doing ell work myself[No workers'cam,insurance required] 9. ❑Demolition
4.F1I am a homeowner and will be hiring connamors m conduct all work on my pmpery. twill 10❑Building addition
pure that all contmceors ether have workers'wmpensarion insurance or are sole 1].0 Electrical repairs or additions
proprietors with no employees.
12. Plumbing repairs or additions
5.[]I an a general contractor ho and I have hired Mese urske s,co listed on the attached shat. 13. @oof airs
These sub<omrzeWrs have empluyces atq have workers comp.insurance.[ I��J �
6.0Weamacorpotabmo dit offs ahaveexemisedtheir6ghtofexcmoon per MGLc. 11
14' Other 2't nl�]% d
152,$I(6),and we have no employees.Mo workers'comp.ivurance required] �LAf.t+xey-,r
'Any applicant that checks box 41 must also fill out the section below showing Meir workers compensation policy information.
I Homeowrers who submit this affidavit indicating they are doing all work and then him outside contractors must submit a new affidavit indicating such.
tCommsemrs Mat check this box most touched an additional sheet showing the name of the sub-conmachan and nate whether or not those antics save
employees. Ifthe subcontractors have employees they mut provide then wotkna'comp.policy number.
I am an employer that is providing workers'compenssadon insurance for my employees. Below is the policy and jab site
information. /
Iosman ,y7re Company Name: A � I�I ,/.,,,
Policy#or Self-ins.p.Lia.1#: bUhl�'gDO' S6U �r530-a2O18 f7 Expiration Date:/�, 3 nk?
Job Site Address: d�l flGIIIaaS & City/State/Zip: /YO( 1vY hobo
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00
and/or ooe-year imprisonment,as well as civil penalties in the tomo 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.
1 do hereby certify u,7nder thepains andpenaBtes ofperjury that me information provided above is true and correct
Simature: .t& &ty Date' 7Ia6II8'
Phone#: L113-533-9247
7
Official use only. Do not write in this area,to be completed by city or town ofciat
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
Content Person: Phone#:
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY
INFORMATION PAGE
A.I.M. Mutual Insurance Company
54 Third Avenue, Burlington, Massachusetts 018030970
(800)876.2765 NCCI NO 26158
POLICY NO. I WMZ-800-8006530-2018A
PRIOR NO. WMZ-800-8006530-2017A
ITEM
1. The Insured: Pro-Tech Waterproofing Solutions Inc.
DBA:
Mailing address: 864 Montgomery Street FEIN:""'6530
Chicopee,MA 01013-3822
Legal Entity Type: Corporation
Other workplaces not shown above: See Location
2. The policy period is from 0529/2018 to 05/29/2019 12:01 a.m.standard time at the insured's mailing address.
3. A. Workers Compensation Insurance:Part One of the policy applies to the Workers Compensation Law of the
slates listed here: MA
B. Employers Liability Insurance:Part Two of the policy applies to work in each state listed in item 3.A.
The limits of liability under Part Two are: Bodily Injury by Accident $ 500,000 each accident
Bodily Injury by Disease $ 500,000 policy limit
Badly Injury by Disease $ 500,000 each employee
C. Other States Insurance: Coverage Replaced by Endorsement WC 20 03 06 B
D. This Policy includes these Endorsements and Schedules: SEE SCHEDULE
4. The premium for this policy will be determined by our Manuals of Rules,Classifications,Rates and Rating Plans.
All Intonation required below is subject to verification and change by audit.
Climielpdti0ns Premium Basis Rates _
Cada Estimated Per$100 Estimated
No. Total Annual Of Annual
R...ois fli Remuneration Premium
INTRA 141050
INTER SEE CLASS CODE SCHEDII E
GOV GOV
STATE CLASS
MA 6229
This policy,Including all endorsements,is hereby countersigned by ���� 7 04/132018
Aorrod.ed Sbnw .. nide
Service Office: HeldEddy a div of HUB International NE LLC
54 Third Avenue P O Bax 709
Burlington MA 01803 East Longmeadow,MA 01028-0709
WC 00 00 01 A(7-11)
indi copyrighted mWl
eel of Via Nauonai court on cnmpenaeamumua,
m I
need wlm I.norot-hon.
City of Northampton
%
Massachusetts w� cQt
a
s
` DEPER04ffiJT OF BUILDING INSPECTIONS
212 Main 9tnwt • Nunitipal Building
` Nortba ton, ax 01060
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 fora 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 preexisting owner-0ccupied 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
r /
Type of Work: 12 D (;O,d h:4Tti 120LALC�YtLvdbt Est.Cost: 9.q. (j.w
Address of Work: ♦1l �I I OAS 'a ,l y l ( narnac 1
Date of Permit Application:
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 founr a building permit as the agent of the owner:
Ii,b-Pch W4fCPFfA ,a16I, Jae 1y1335
Date Contradtor Nanig 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
c_
I DEPARTMENT OF BUILDING INSPECTIONS
212 Main Btteet *l icipel Building
Northampton, MP 01060
Debris 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 property licensed solid waste disposal facility, as defined by MGL c 111, S 150A.
The debris from construction work being performed at:
B9 WillIams (_3
rl�ax��� hkl Q�omo
(Please print house number and street name)—�
Is to be disposed of at:
JLpI� LV/2LLLxs
(Tease pont name end location of facility)
Or will be disposed of in a dumpster onsite rented or leased from:
(Company Name and Address)
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.
_ OM.ofComusner Atfal.&&innsR gol �„dh
RegWadm
HOME IMPROVEMENT CONTRACTOR
;:: RoWatradrn: 144335 Type:
Expiration: 9242018 Private Corporation
PRO.TECH WATERPROOFING SOLUTIONS,INC.
RONALD GILPATTRICK
804 MONTEGOMERY ST-
CHICOPEE,MA01013 Underreeremry
Lireme or registration valid for iadfvidoai an"IT
before the expiration date. If found Wum 0:
Office of Coasuaur Affairs and Business Regulation
Ill Park Piam-Snit*5I70
Boston,MA 0211F
July 26,2018
City of Northampton
Building Department
To Whom it May Concern,
Pro Tech Waterproofing informed me that their Construction Supervisor Gill Gilpatrick's CSL license
expired in April 2018. 1 understand that his renewal is currently in process. While this is in process, I am
fine with Pro Tech proceeding with the work at my house at 89 Williams Street.
Please feel free to contact me with any questions.
Best Regards,
Kirstin LaMonde
802-338-8346
7/27/2018 C+mail-Department of Public Safety Aulhodzed Payment Confirmation
MGmail Gisela Gilpalrick<protechwaterproofingsolutions@gmail.com>
Department of Public Safety Authorized Payment Confirmation
1 message
BillMatrixNext.Support@f'isom.com<BiliMatrixNext.Support@fisew.com> Fri, Jul 27,2018 at 2:59 PM
Reply-To: BillMatrixNext.Support@fiserv.com
To: protechwaterpmofingsolulions@gmail.com
This is an electronically generated acknowledgement of your payment to Department of Public Safety Payment. Please
print this message or save it on your computer for future reference.
Here is your payment information:
License Number: CS-095913
Payment DateRme: 7/27/2018 2:47:40 PM(ET)
Payment Amount: $100.00
Convenience Fee Amount: $2.30
Method of Payment: MasterCard Debit
Card Number: ""'9545
Confirmation Number: H44815
https://mail.google.cam/maivu/1Rui=28ik=395cif8cSb8jsv FN03PNISPMI.en.&c l=gmail_le_180717.14_p68viev-pt&search=inbox&th=164dd1cfb... 1/1
Home Builders & Remodelers Association
of Western Massachusetts
Course Completion Certificate
For
Gill Gilpatrick- CS-095913
CE Class HBRAWM July 26,2018
CS-0707 Builders Intro to HVAC Both Old and New(1 Hour Code/1 Hour Energy)
CS-0710 Fall Prevention&Silica Exposure(IHour Safety/1 Holo Business)
CS-0701 Constructing,Building,and Operating a Super Insulated Home(1 Holo Energy/1 Holo Elective)
CE Class HBRAWM July 27,2018
CS-0716 IECC 2015 Energy Code Review(1 Hour Code Review/l Hour Energy)
CS-0717 Transition From 8th Edition to 9th Edition MA State Bldg. Code 780 CMR-(4 Hour Code Review)
'I'be Home'mWers and Th,num.'hal.. W
Re.w.M Axmalutinn of RemMelers Avarlution mv1 CSL
O'estern hlussxrbusals is xn �hlaaachusxas is un npprovM CSL
appal CSL Cantiuuing Continuing Edueution
Eduealian Coordioatar.Appr .11 CmNinalor:APProral Mnmher.
�umbee('SI.CD4llQ9'naa CSLCD0W7 Sandra nuueetl..
Smile.
Gill Gdpaai.k
Ro-T¢h oofin6 Solwa u,Inc.
t'hone: 864mofflgm
GmttOM
(41l)A}Bil: twtwawpm
fln
lutq � l.am
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PRO-WAT-01 MMAT
4`ORo CERTIFICATE OF LIABILITY INSURANCE °07127 018
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 live cartigca[s holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provision.or he endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on
this ceni0cate does not confer rights to the cenmcaM holder in lieu of such endorsements.
PRODUCER License#i7WW2 CONTACT Monique Matz
HUB akerned. New England wNCNe.Ex : �.4v�oJ:__
EastORE
98 Long Rd. .moni ue.ma hubntemattonal.com _
East Longmeadow,MA 01028 9_ �
INSU0. S AFFO NGCOVE W .1
IxSUMBA:Employers Mutual Casualty Company 21415
INSURED INSURER B:FmuclulM InNlablar NMnuMwee Mutual Mpunnra Cwnpen 33758
Pro-Tech Waterproofing Solutions,Inc. means.c:
864 Montgomery SL IxsuRER° _
Chicopee,MA 010133822 INSURER E:
INSURER IF
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.
IISENI
N3R .m UNUMXCE AaM SUDU RE.NUNBER POLICY EFF PoIKYEP DMIS
A % '.CONNERCMLGAUNERALLJAeurr EALHOOCURRENCr t_ 1.000,000
obaG€TO RENTED 500,000
cwIMSMADE ❑X occua 7669919 05129/2916 0512912019 P § - _ _..
ME.EXP(Affane a 10,000
PERSCNALa ADVINJURY § 1r000'000
GEN'LAGGREGATE LIMTAPPLIESPER. GENERALAGGREGATE $ 2'000'000
o —
POLILYu JECT 1:1LGC PRODUCTS-CdAPIOP A. 21000,000
OTHER:
A FV
POS,EUEUuNNUrD, CpIBwED SINGLE LIMIT E1,000,000
ANYAUTD 669919 05129/2018 05/2911019 ED OWNED SCHEDULED
AUT.S ONLY CTrvOE HOMILY INJURJPerauva ) E
AUTOS ONLY X. AUTOS ONESOP�ERdYI NMGE - f
A X UMBRELLALW X OCCUR EACH OCCURRENCE S 1,000,000
E%CE.Su CUMMSANDE 4.176611919 05/2912016 0512912019 AGGREGAT S 1,000,000
DEO I X I RETEMIONE 10,000
B VroRKERSCOXPENSATWX PERTUTE
AND OT1-
'MYEMPL°YERe'IATTERY � MZ40040065304018A OWMI201305DEV2019 - 500,000
OFFIANYCENMVBOR EXCLUDED?
Ix E.L.EACH ACCIDENT b
,uRo WMEMOER EXCLUDED9 IIIA
IManaumyNnxl E1.plsEnsE-.EAEMPLovE. E_ _. 500,000
nya6f'e oe ower _. 500,000
DESCRIPnon OF CPEMnous Oelom E.L.DISEASE-Poucr uMlr
A Hired Car ColllComp 76699190512911016 DWM2019 Deductibles 500
A Commercial Amomobil 7669919 05/29/2018 05129/2019 Collision deductible 500
DESCRIPTION OF OPERATpMS I TO TIOUNIXE1aCLES (ACORD 1.1,AJA —d Reme,es Sk IvxI mry M+ NM If epeuunniM)
Umbrella schedule of uLMetlyem Includes me General Liability and Auto policies
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Kristin LaMOndb THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
89 Williams Stand
Northampton,MA 01060
AUTNOR°ED REmESEXTATIVE
ACORD 25(2016/03) 9)1986-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
®, Massachusetts Department of Public Safety
Board of Building Regulatidns and Standards
License: CS-095913
Construction Supervisor
GILL J 04LPATFUCK
O3 STEBBINS STREET
CRICOPEE MA 01020
Expiration: _
Commissioner 04129MOis
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#642018a
864 Montgomery Street, Chicopee,MA 01013-3822
Phone: 413-533-82171800-734-8217
Email: pmtechwaterproofingsolubons@gmail.mm
www.protechwaterproofiracom
MA REG#:144335 CT REG#:602175
6/4/2018
Kristin Lamonde 802-338-8346
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Re: 89 Williams Street
Northampton, MA
Re: Bowing in of northside foundation at stairway
1. Remove stairway and set aside
2. Brace existing to beams to support.
3. Remove approximately 10'-12' of bowing foundation and discard at legal dump site
4. Install 8"X 16"footing with 3500# concrete with 2 -#4 rebar
5. Install 8"X 8"X 16" bock foundation with Dura-wall wire reinforcement and a#4 rebar
every 4' filled with concrete.
6. Waterproof new section of wall
7. Backfill
8. Reset stairs
PRICE: $7,800.00
Patch any major loose mortar and holes.
PRICE: $580.00
Correct grade on rear of foundation.
PRICE: $1,350.00
Existing Plant Materials: We will do our best to save but there is no guarantee as to the
survival of the plantings. Any bushes, flowers, etc you want to keep are to be removed by
owner. We will do our best to put back in same spot but we are not responsible for damagedl, �`\k
or missing plants. Plant materials to be watered regularly and thoroughly by owner.
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Because we can't always know the conditions below grade, if ledge, stones, or conditions that
require additional work, such as jack hammering, there will be an additional charge of
$80/hr/man plus equipment charges that apply.
Any areas that can not be seen at the time of estimate that need to be addressed, there will
be an additional charge of$80/hr/man plus materials or equipment charges that apply.
Any extra work asked of our employees will be charged as an EXTRA at$80/hr/man
plus materials no matter how small.
We accept cash, checks,American Express, Discover, Master Card& VISA
We do work in the order that deposits come in.
All accounts are subject to a 1-1/2%per month(18%per annum)charge on amounts 30 days past due.
If account is turned over for collection the above agrees to pay all court costs and attorneys fees.
35 years of keeping basements dry.
Family owned and operated. Fully licensed and insured.
Paymentt o be made as follows:
1/3 in advance to get on job schedule, 1/3 day work begins,1/3 day work is completed
We accept cash,checks,American Express, Discover, MasterCard&VISA
**** If proposal is accepted, please sign 1 copy of proposal
and return with deposit to our office.
(You will then be put on our job schedule board)
*** Proposal MUST be signed before any work will start.
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Acceptance of Proposal—The acme prices eud
Conditions are satisfe Tory and are hereby ac¢pted. You are slEftanu'e. _
authorized to do the work ae spoubed. Payment wig be madeu
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(P'isI !1 i sign e.
DATE OFACCEPTANCE: 'i
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7127/2018 https://elice se.chs.stale.ma.usleGmNVeWPaymentResult.aspx?answer-pmmssed&payment_id=66224&process=REN&fee_amounri...
Application Submitted
Your application has been submitted and all fees have been applied to your credit card. Please print this page as your proof of
submission and receipt of payment.
Application Information
ate Submitted: Friday,July 27,2018
pplicant Name: GILL J GILPATRICK
icense Number: CS-095913
gency: MADPS
rocess: Renew License process
Payment Information
Authodzation Code: H44815
Received Date: 7/2712018 2:47:40 PM
Received Amount: $100.00
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