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38A-107 (5) 11 VILLAGE HILL RD BP-2019-0316 GIs#: COMMONWEALTH OF MASSACHUSETTS MMLBlock: 38A- 107 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:renovation BUILDING PERMIT Permit# BP-2019-0316 Project# JS-2019-000510 Est. Cost: $92500.00 Fee: $651.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: CROCKER BUILDING CO INC 086799 Lot Size(sq. ft.): 38027.88 Owner: 11 VILLAGE HILL LLC Zoning: PV(100)/ Applicant. CROCKER BUILDING CO INC AT: 11 VILLAGE HILL RD Applicant Address: Phone: Insurance: 186 STAFFORD ST (413) 737-7803 Workers Compensation SPRINGFIELDMA01104 ISSUED ON.9/16/2018 0:00:00 TO PERFORM THE FOLLOWING WORK.RENOVATE OFFICE SPACE FOR HAMPSHIRE COUNTY SHERIFFS OFFICE -NEEDS FD APPROVAL- 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 Sienature: FeeTvpe: Date Paid: Amount: Building 9/16/2018 0:00:00 $651.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2019-0316 APPLICANT/CONTACT PERSON CROCK R BUILDING :;O INC ADDRESS/PHONE 186 STAFFORD ST PRINGFIELD .'.11.l3)737-,803 PROPERTY LOCATION 11 VILLAGE HIL .RD MAP 38A PARCEL 107 001 ZONE PV(1 )/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid T_ypeof Construction:_RENOVATE OFFICE SPACE FOR HAMPSHIRE COUNTY SHERIFFS OFFICE New Construction aff2g=H N66h§' fTce"y k(, Non Structural interior renovations Addition to Existing Accesso1y Structure Building Plans Included: Owner/Statement or License 086799 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: proved Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Permit With Site Plan Major Project: Site P16 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 / ?/16 Signature of Building 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. P043 ­ Versionl.7 Commercial Building Permit Ma 15,2000 Department use only City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability Northampton, MA 01060 Two Sets of Structural Plans phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans________ Other Specify_ APPLICATION TO CONSTRUCT, REPAIR REN VATE CHANGEJHE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER MILY i WELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: SEP 1 201$ hissectionto be completed by office 11 Village Hill Rd Map 3& Lot /07 Unit DEPT OF BUILDING INSPECTIONS NORTHAMPTON.r,A20r190 Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name(Print) Current Mailing Address: f Signature Telephone 2.2 Authorized Agent: 416- f'1011104 0., A4 Name(Print) Current Mailing Address: 013) 7p-_7frrv3 Signature h Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only com feted by permit applicant 1. Building (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) ���' 5. Fire Protection17 6. Total= (1 +2+ 3+4+5) Check Number Lt This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner/Inspector of Buildings Date S 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 ❑ Existing Wall Signs ❑ Demolition❑ Repairs❑ Additions ❑ Accessory Building❑ Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other ❑ Brief Description Enter a brief description here. Renovate office space for Hampshire County Sheriffs Office Of Proposed Work: SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑ A-4 ❑ A-5 ❑ 1B ❑ B Business 0 2A ❑ E Educational ❑ 2B I ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ 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 0 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: B Proposed Use Group: B 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 Floor Area per Floor(sf) 1St 1St rtAOVA4•. Arty 2nd 2nd 3 rd 3rd 4 4th th Total Area(sf) Total Proposed New Construction (sf) Total Height(ft) "ZS Total Height ft 7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information: F7Sewage Disposal System: Public Private E] Zone Outside Flood ZoneE] icipal 0 On site disposal system❑ Versionl.7 Commercial Building Permit May 15,2000 8. NORTHAMPTON ZONING Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg. Square Footage Open Space Footage % (Lot area minus bldg&paved parking) #of Parkin Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DON'T KNOW YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO t DON'T KNOW YES Q IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO Q DON'T KNOW 0 YES l IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained l Obtained 0 , Date Issued: C. Do any signs exist on the property? YES NO 0 IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES i NO Q 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. Version 1.7 Commercial 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: CcJfz'Rs �j� Not Applicable ❑ Name(Registrant): 7352 C:7.40LOP� b �s��e. 2^I � l^ Registration Number Addr �` `r`'r�• ���/� 8/31/2019 (413) 594-2800 Expiration Date Signa ure Telephone 9.2 Registered Professional Engineer(s): 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 Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date 9.3 General Contractor Crocker Building Co., Inc. Not Applicable ❑ Company Name: William Crocker Responsible In Charge of Construction 186 Stafford St., Springfield, MA 01104 Address (413) 737-7803 Signature Telephone i Versionl.7 Commercial Building Permit May 15,2000 SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes 0 No SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT Frank Fitzgerald as Owner of the subject property hereby authorize Seth Crocker to act on my b alf, atters rel a work authorized by this building permit application. 9/10/18 Signatur f r Date ism 1 Seth Crocker as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Seth Crocker Print Name hl 1/nae Signature of Owner/Agent Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: If', 6- - Of(7? q License Number 186 Stafford St., Springfield, MA 01104 1 l /2t /2C-1,P Address Expiration Date (413) 737-7803 Signature Telephone SECTION 13-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 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: /law� All Rd, The debris will be transported by: The debris will be received by: Building permit number: Name of Permit Applicant Crs'i'G(r P'a/ �,c �l Date Signature of Permit Applicant i The Commonwealth of Massachusetts Department of Industrial Accidents .0 1 Congress Street, Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual):Crocker Building Co. , Inc. Address:186 Stafford St. City/State/Zip:Springfield, MA 01104 Phone #:(413) 737-7803 Are you an employer?Check the appropriate box: Type of project(required): LQ I am a employer with 20 employees(full and/or part-time).* 7. ❑New construction 2.F�I am a sole proprietor or partnership and have no employees working for me in 8. [Z] Remodeling any capacity.[No workers'comp.insurance required.] 9. El Demolition 3.F_1 I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10 E] Building addition 4.F I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole I L❑Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.0 Roof repairs These sub-contractors have employees and have workers'comp.insurance.1 6.R We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] IL *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 state whether or not those entities have employees. If the sub-contractors 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 the policy andjob site information. Insurance Company Name:Liberty Mutual Insurance Co. Policy#or Self-ins. Lic.#:XWO1957699399 Expiration Date:4/1/19 Job Site Address:11 Village Hill St. City/State/Zip:Northampton, MA 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 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. I do hereby certify under the ppainssaandpenalties ofperjury that the information provided above is true and correct. Signature: ,"d& Date: Phone#:(413)737-7803 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#: Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards I Constr4ctfbn tupervisor I I CS-086799 FW i res: 01/22/2020 a _ ERNEST E LAGACY JR 615 SUFFIELD-ST AGAWAM MA 0,1.001 Commissioner l.Jk Initial Construction Control Document To be submitted with the building permit application by a M Registered Design Professional for work per the 91h edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Hampshire Sheriff's Department Tenant Fit Out Date: Semptember 6,2018 Property Address: 11 Village Hill,Northampton, MA 01060 Project: Check(x)one or both as applicable: New construction®Existing Construction Project description: Renovations to an existing tenant space to serve as the offices for the Hampshite Sheriff's Department I Curtis A. Edgin ,MA Registration Number: 7352 Expiration date: August 31,2018, am a registered design professional, and I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning': ®Architectural Structural Mechanical Fire Protection Electrical Other: for the above named project and that to the best of my knowledge, information,and belief such plans,computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR),and accepted engineering practices for the proposed project. I understand and agree that I(or my designee) shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. When required by the building official, I shall submit field/progress reports(see item 3.)together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to the building official a `Final Construp.toW63tftrql Document'. Enter in the space to the right a"wet"or electronic signature and seal: LL k Phone number: 413-594-2800 Email: cedgin@cbaarchitects.net Building Official Use Only Building Official Name: Permit No.: Date: Note 1.Indicate with an`x'project design plans,computations and specifications that you prepared or directly supervised.If`other' is chosen, provide a description. Version 06 11 2013 Security & Fire Integrations LLC 73 Gunn Road Southampton MA 01073 Fire System Narrative 9-11-2018 Location: Hampden County Sheriffs @ Village Hill 11 Village Hill Road Northampton MA 01060 Contractor: Crocker Builders 186 Stafford Street Springfield MA 01104 413-737-7803 Installer: Security& Fire Integrations LLC 73 Gunn road Southampton MA 01073 Brian Hackworth 285C 413-563-8069 Use Group: B Fire System: The building system is a Silent Knight 5820 addressable control located in the back mechanical room. The system shall be installed and added onto the system in the front Sheriffs office unit. SFI LLC shall add and or re use the equipment already installed in the unit. SFI LLC shall test and provide NFPA 72 Test reports when completed. Office 413-203-2008 / Fax 413-203-2015 www.securityfireintegrations.com Operations: The Fire System upon activation of the initiating devices shall cause the system to go into full alarm. Activating the Visual and audile horn strobes in the building as well as the outdoor red beacon. The system will also dial the UL central station to report alarms,troubles and supervisory. To silence the system at the annunciator located in the middle entrance press silence then 1111,to reset press reset then 1111. Equipment: This will be added to the existing system 2 Smokes add to storage room 4 Smokes add to office areas 2 Pull stations re-use 2 Strobes re-use 2 Horn strobes re-use 1 Horn strobe storage add Office 413-203-2008 / Fax 413-203-2015 www.securityf irein tegrations.com ­—IMMIN CROCBUI-01CHRISTINE A 1:D0� CERTIFICATE OF LIABILITY INSURANCE D 0 111120Y8 09/11/2018 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(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WANED, 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 c MJACT Christine Sullivan Phillips Insurance Agency,Inc. PHONE F 97 Center Street Arc,No,Ext):(413)594-5984 A No:(413)592-8499 Chicopee,MA 01013 E-MAI .christine@phillipsinsurance.com INSURERS AFFORDING COVERAGE NAIC M INSURER A:West American Insurance Co. 44393 INSURED INSURER B:Ohio Security Insurance Co _ 24082 Crocker Building Company Inc INSURER C:Ohio Casualty _ _ 24074 186 Stafford St INSURER D: Springfield, MA 01104 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 LTRTYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF yyy, POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1,000,000 CLAIMS-MADE X: OCCUR BKW57699399 04/01/2018 04/01/2019 DAMAGE TO RENTED $ 300,000 rence)_ MED EXP(Any one $ 5,000 PERSONAL 8 ADV INJURY 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 2,000,000 POLICY[:]jreT n LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 X ANY AUTO BAS57699399 04/01/2018 04/0112019 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ H��Ep L 1 Na%glED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ C X UMBRELLA Luke X OCCUR EACH OCCURRENCE $ 10'000'000 EXCESS UAB CLAIMS-MADE US057699399 04/01/2018 04/01/2019 AGGREGATE 101000,000 DED I X I RETENTION$ 10,000 C WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY XW057699399 04/01/2018 04/01/2019 1,000,000 ANY PROPRIETggOEER/PARTNER/EXECU I WE Y r N E.L.EACH ACCIDENT 8UandER/M In NH)EXCLUDED? N r A E.L.DISEASE-EA EMPLOYEE 1,000,000 Ifes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below _ E.L.DISEASE-POLICY LIMIT A Electronic Data Proc BKW57699399 04/01/2018 04/01/2019 Rented Eq 200,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Project: Hampshire County Sheriffs Office 11 Village Hill Northampton MA 01060 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cit of Northampton THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Y P ACCORDANCE WITH THE POLICY PROVISIONS. 212 Main St Northampton,MA 01060 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) C 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CROCBUI-01 CHRISTINE ACORD CERTIFICATE OF LIABILITY INSURANCE FDATE 091(MM/11122018018 Y) 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 endorsement(s). PRODUCER CONTACT Christine Sullivan _NAME: Phillips Insurance Agency,Inc. PHONE FAX 97 Center Street A No,Ext:(413)594-5984 (A/C,Ne):(413)592-8499 Chicopee,MA 01013 JbmpAg1kss christine phillipsinsurance.com INSURERIS)AFFORDING COVERAGE NAIC#_ INSURER A:West American Insurance Co. 44393 INSURED INSURER B:Ohio Security Insurance Co 24082 Crocker Building Company Inc INSURER C:Ohio Casualty 24074 186 Stafford St INSURER 0: _ Springfield,MA 01104 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY1,000,000 EACH OCCURRENCE CLAIMS-MADE j OCCUR BKW57699399 04/01/2018 04/01/2019 DAMAGE TO RENTED 300000 _ Tencel $ MED EXP(Any oneperson) 5,000 PERSONAL 8 ADV INJURY 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE 2,000,000 PE� 7 LOC PRODUCTS $ 2,000,000 POLICY E OTHER: B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Edent) $ X ANY AUTO �BAS57699399 04101/2018 04/01/2019 BODILY INJURY Perperson) OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident C X UMBRELLA LIAB X OCCUR EACH OCCURRENCE 10,000,000 EXCESS LIAB CLAIMS-MADE US057699399 04/01/2018 04/01/2019 AGGREGATE It 10,000,000 DED I X I RETENTION$ 10,000 C WORKERS COMPENSATION X PER OTH- STATUTE I AND EMPLOYERS'LIABILITY XW057699399 04/01/2018 04/01/2019 CUTIVE Y 1,000,000 ANY PROPRIETOR/PARTNER/EXE ❑ E.L.EACH ACCIDENT $ WFICER/MEMBER EXCLUDED) NIA andatoryinNH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 Ii es,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT A (Electronic Data Proc BKW57699399 04/01/2018 04/01/2019 Rented Eq 200,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) Project Location: ast project at 90 Carando Dr Springfield,MA CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cit of Springfield THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN YACCORDANCE WITH THE POLICY PROVISIONS. 70 Tapley St Springfield,MA 01108 -- AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD t v City Of Louis Hasbrouck<Iasbrouck@northamptonma.gov> Re: Hampshire Sheriff at 11 Village Louis Hasbrouck<Iasbrouck@northamptonma.gov> Sun, Sep 16,2018 at 12:44 PM Draft To: Seth Crocker<scrocker@crockerbuilding.com> Seth, haven't heard from the Fire Department yet, but I've signed the permit contingent on their approval. I'll let you know if they have comments or want changes. The only things I see are relocated sprinkler heads(need shop drawings or narrative), and it looks like the interior door to the sprinkler room was eliminated. I don't know what they will want; maybe additional signage and a key to the sprinkler room in the Knox box. Louis Hasbrouck Building Commissioner City of Northampton Town of Williamsburg (413)587-1240 office (413)587-1272 fax On Wed, Sep 12, 2018 at 6:30 PM, Louis Hasbrouck<Iasbrouck@northamptonma.gov>wrote: Seth, OK to start demo. I sent plans to the FD;they'll let me know if they want anything pretty soon. Louis Hasbrouck Building Commissioner City of Northampton Town of Williamsburg (413)587-1240 office (413)587-1272 fax On Wed, Sep 12,2018 at 11:57 AM, <scrocker@crockerbuilding.com>wrote: Louis, Here are the plans for this project in pdf format. Are you ok with us starting on the demolition while the application is being reviewed? The demo is primarily carpets,a couple of doors and a small amount o of nonbearing partitions. Seth Seth Crocker,Vice President 1,'CBC Ful logo