05-020 (13) 395 AUDUBON RD BP-2019-1083
GIS 4: COMMONWEALTH OF MASSACHUSETTS
MV,.Block:05-020 CITY OF NORTHAMPTON
Lot.-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Caregorv:ROOF BUILDING PERMIT
permit BP-2019-1083
Project# JS-2019-001766
Est.Cost: $28500.00
Fee:$188.50 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor., License:
Use Group: SEXTON ROOFING CO 99689
Lot Size(sa.R.1: 386377.20 Owner. BASKIN LISA&LEONARD
Zoning RR(102)/WSP(25y Applicant: SEXTON ROOFING CO
AT. 395 AUDUBON RD
ApplicantAddress: Phone: Insurance:
P O BOX 6327 (413) 534-1234 WC
HOLYOKEMA01041 ISSUED ON.41212019 0.00.00
TO PERFORM THE FOLLOWING WORK.STRI P & S H I NG LE 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 Occupancy Si®atu e•
i
FeeTyPe: Date Paid: Amount:
Building 4/2/20190:00:00 $188.50
i
212 Main Street,Phone(413)587.1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
�Z6p F �.TV a 2,?
DepartmeDt use only
City of Northampton Status of Permit
�+ Building Department Curb CuVDnveway Permit
' 212 Main Street Sewer/Septic Availabiliry
Room 100 Water/Well Availabiliry
Northampton, MA 01060 Two Sets of Structural Plans
phone 413587-1240 Fax 413-587-1272 PloliSite Plans
Other Speciy
APPLICATION TO CONSTRUCT,ALTER,REPAK RENOVATE OR YOIRll' LV LLING
MATION RE
SECTION 1 -SITE INFORo J— OW Ann 6,0— 14—16 8 j
1.1 Prr(tooarly AAddrres : // ,, /1 r/1 b la * t by e
./ J ' rV�UOO"' D• wp NORTHRMnT057F TIONS UnR
4P20 S Zone
✓r'r' r "10
10 Elm SL District CB District
-
SECTION 2-PROPERTY OWNSOHNIAUMOMM AGENT
2.1 Obnsr of Record:
L7 s a
40
NamePd3utiWV dress
Tekwmane
2.2 Authorlmd Agent
Name(Frill Curbs Naing Address:
-'3 V/23
Signalure Tebpbdle
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estinated Cost(Dollars)to be ORpal Use Only
carnpleted by it 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 Protection
6. Total=(1 +2+3+4+5) Check Number a
This Seedw For Official Use Only
Budding Permit Number. Dass
Issued:
BignaWre: LI-z-za9
BWtlig Canmietiacrdnspedar of 1ludtligs Date
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
L f l�2
i _._� .. _..i
1
i
, ,
L
Section 4. ZONING All informationPermit & nue
krst Be Completed.Permit Can Denied 7o Incarrlplet nfomatton
Existing Proposed Required Zoning
This cel to be filled in by
BmNi
Lot Sim
Frontage
Setbacks Front
Side L: R: L: R:
Rear
Building Height
Bldg.Square Footage %
Open Space Footage %
(let mea minus bldg&Msed
N of Parkin Spooes
Fill:
A. Has a Special Permit/Varian[ Finding ever issued for/on the site?
NO O DONT K W O YES O
IF YES, date issued:
IF YES: Was the permit r ded at the Registry of ?
NO O KNOW O YES O
IF YES: enter Page and/or Document k
B. Does the site contain brook, body of water or wetlands? NO O DONT KNOW O YES O
IF YES, has a it been or need to be obtained from [he onservation Commission?
Needs to be ined O Obtained O , Date Issued:
C. Do any signs "st on the property? YES O NO
IF YES, ribe size,type and location:
D. Are there y proposed changes to or additions of signs intended for the roperty? YES O NO O
IF YES describe size, type and location:
E. Will th consbuctim activiily disturb(rdeadng,grading,excavation,or filling)over 1 acre s d part of a common plan
that II disturb over 1 acre? YES O NO O
IF YES.then a Northampton Storm Water Management Permit from the DPW is required.
SECTION 5- N OF PROPOSED WORK l0wir all alfidicab4t,
New House ❑ Addition ❑ Replacement Windows Alterationjs) ❑ Roofing
Or Doors O
Acoessory". ❑ Demolition ❑ New Signs [DJ Decks 10 SWingl aber(Io
Brief WorkDesmGaonolRoPosad #
Alteration of existing bedroom_Yes_No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes _No
Plans Attached Roll -Sheet
5a. N New house and or addition to existing housing, complete the following:
a. Use of building:One Family Two Family Other
b. Number of rooms in each family unit. Number of Bathrooms
-
c Is there a garage attached -
d. Proposed Square footage of consWction. nsions
e. Number of atones?
I, Method of heating? Fireplaces or Woodstmes Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
K Type of construction
I. Is construction within 100 ft.of ands?_Yes No. Is construction within 100 yr. floodplain_Yes No
j. Depth of basement or ce r moor below finished grade
k. Will building cordo to the Building and Zor ng regulations? No.
1. Septic Tan City Sewer_ lonvale well City water Su
SECTION 7a-OWNER AU71IO1111¢IITION-TO BE COWLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BULDNIf-PERIQT
I, Id as Owner of the subject
property
hereby authorize Q O
b et mylbehalf,in all mailers relative work augaraed by this building 0ennit application. o/
Signewre of Owner Date
I, g zas Owner/Authorized
Agent..ereby declare that themeand ematim oro Wekregoing application are We and accurate,to the best of my knowledge
and belief.
Sig utire ia 'es of ry.
PonNanw
Z l
OMI&IAgent Dab
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Cons WNot Applicable
Name of Lieeme Hd � 9gle
r /
license Number
Address �� E,V;,a„w DaN
$grialwe Telephww
2,111leatetered Home c /J Not Applicable ❑
Com �J Registration Number
1 /fFxpmBon Data
(IQ d/ o/ �Telaph.--"2 {�Z
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.O.L.c.15Z S 25C(6)(
Workers Compensabon Insurance affidavit must be completed and submitted with this application. Failure to provide this afhdava will result
In the denial of the issuance of the building permit.
Signed Affidavit Attached Yes....... No...... ❑
City of Northampton
% F H89S8CIlR9nLLS W2sr r�i
\ II212 bftiIVT OF BOIZ ict Za8F8GTZ098
313 qin rt e,, • , Hi 010 auildiny j, T
_ NortAmytov, IN 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 four family homes.Prior to
performing work on such homes,a contractor most be registered as a Home Improvement Contractor("HIC").
M.G.L Chapter 142A requires that the"reconstruction,afteration, renovation, repair, modernization, conversion,
improvement removal, demolition,orconslnrction of an addition to any pre-existing owner-0 pied building containing
at least one but not more than four dwabng unifs....or to structures which are adjacent to such residence or building" be
done by registered contractors.
Note:Ifthe bomeawaer has coadacred wiek a corporation or LLC,that entity must be registered
Type of Work Est.Cost:
Address of Work:
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 owmxoccupied
_Other(specify):
OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED
CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE NOME IMPROVEMENT WORK ARE NOT
ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND
UNDER M.G.L.CMphr 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK
PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION.
Signed under the penalties of perjury:
I hereby apply for a build* trait as the agent of the owner:
Date Contractor Name ^—� HICRegistration 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
f Massachusetts
l212] IIgT OF 8or iaaa l Dul nq i.
212 asin Street •lNnici 01 Building i
eorthagrton, as 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:
, � `1 �- &"� 8,n/
(Please print house number and street name)
Is to be disposed of at:
(Please print name and location of facility)
Or will be disposed of in a dumpster onsite rented or leased from:
(Co ny 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.
Proposal
SEXTON ROOFING AND SIDING INC
www.sextonmofing.com
MWO
Setting the Standard
P.O. Box 6327
p. 413.534.1234 Holyoke, MA 01041
E 413.539.9906
MA HIC# 118739
sextonroofmg(�hotmafi.(wm
SUBMITTED TO Lisa Basiis PHONE SLS-GM RUE 4&Mwis moi` fr
STREET 395 Aoda6m RL 1,TOBNAhffl BauBeef
CITY,STATE,ZIP Le4 Ma. - JOB LOCATION
SEXTON ROOFING HEREBY SUBMITS SPECIFICATIONS AND ESPIMATES FOB:
1) Strip and remove existing shingles and dispose of in proper landfill.
2) Inspect roofing deck and replace as needed 111)$4.00 per in.R. or$80.00 per sheet.
3) Install new metal edging to rakes and eaves of roof. (811)
4) Install int and water shield on eaves(6'),and at intersecting roofs.
5) Install#15 synthetic roofing felt on remainder of roof.
6) Install starter shingles on eaves and rakes of roof.
7) Remove skylights and pad in the plywood to match existing thickness.
i8) Install IRO Architectural style roofing shingles as per manufacturers'specifications. 50 YR .
9) Supply manufactures Lifetime warranty and SRC 15 yr. workmanship warranty.
ALL CONTRACTS INSURED WITH PROPERTY LIABILITY AND WORKMANS-COMPENSATION.
Pkaa m be sure to cone,or remove nduables in attic due to fatting debris during mmtrurrion.We assume no rwpomitlhty for
!damaged arms.
We Propose hereby to furnish matepp(and labor—complete In accordance with the above specification;for the amount of
Twenty Eight Thousand Fiv3WoflM($28,500.00)Payments to be made as fdbws Due in ftdl upon completion
All Matcoalisgtunn2Wmteuspecified ABwaittabeaompktedina Authorized 215 N.I{r(AI
wod nlikemanneraccordingmnandardprxsim. Anyahmm nor Signal— fir , 1
deviation tom at nw specifications umalvetgema nab WE be eiacw<d {9
onty upon written orders,and will bcmrrc an rema dare,ercand abne I
We esnmam. All a®eemenn mntingnt upon mid amdnb wddays
beyond our monol. Not nayonnbk for wamdamage dudngmmo-uruoo. Note:This plup sal my be withdrawn by ns if not accepted
0.to pay tespouibk legal fees for non-payment,and.ppIiab1nintuits, within(19)Jaya
Acceptance of Proposal The above prices,
sped,—nom and conditions are satisfactory and are hereby Signature
accepted. You are authorized to the work as specified.
Payment will be made as outlined above
l Due of Aooeptan¢ swat=
'�� T. -
� ' $
.Y _
.. - � y
� *� " ��.
_ yr'
.. : . .. *
� � . ..
. a _ _ _
` �d�t.
_ � _ ri%,
1..
�. ..
} -.
_ P
The Cormaromnedta ofM�rhuwfts
Dq—bnent oflndmtridAcddenIs
I Congress Sbee4 sm*e 100
Boom,MA 02114-1017
www.masgov/dia
Rorhers'Compem9tioa la3araafe ABMavth.Bv7darsMamt.�.ao.sta't--� -•../Ytombers
TO BE FHXD WffH 3NE PFItWrI .AUYNDU Y- rn
Apatieant Lforutatm PleasePrint Lybly
Nie �:Staldott RooStg 8 Sit&rtg Inc _
AddrumP.O_BM6327
ityMP-t •Y�01040 Phtme.41S.534-1234
M)�>•mPaOw'yOrdlmganar'wa:ie=
-
Type of project(regmvd)_ .
,.LL']t�.enpbyc..eti empbym(fWl dlwpatame}•
7. ❑New moshocfim
2�i§oasdvpcpimrwptmstipdmcm�loy�wo�g fwmcio >L Rmodelmg
ap4y-pvoaatra'ap iwcaa nyud.]
301maammoQdmgag.w .My 9. QDemolibon
4.❑Iasatvawv.mwadrallmmog cmbadan®ietdluakmmy pvpaly. Iwo 10_[]Building-addition
®i�iavOewa7aeibem•eweatm• ��wmmle ll.❑Elv4ical repairs or additiom
p.opo�wdhoo.aplgee
12pptvmbmg repairs or additions
S�i lm ageadrartamrdlm+e titdtm ai m4rIDrs•.. •mPoe-"- . .shna 13.❑8aoftepahs
Nrsaohowar�Yw mpbymdmesodva'oay�t L�'"y"v
ti�We 11(4), nmmd awp& s.wem�nl lheti�lafevapGm pv MQ.c 14"❑Dilter
1R 4t(gdawm.em a�R+a.radas•meQ.®vmsmw'ernl -
-Any ayfow rlerbhoru tttrmalml8 ut Nea1m odor dwq;ihQ.odm'maacm'eaap^i�f traetdm
iBmm.mswbadit'm dSGdaiid�EirY aedo�aGvodcdtm YwotrideA emvtateradaiiaeva6dar.sti�ga h
tCmasaetmtdlydcricherumemrbedmdd�nml siendovigtpeoQ d'dr:aW>mrmtsdfltitl4eacmrthoQeanels.e
caaiyra Ddsabmmm¢mteaepbF,iry vanpo.i�6Q aamm'®p policy®bc.
IewpA"erth rapn dbgnrmgeefwsyuWd" BeApwis thepaicy dlob.me
faforaeoana.
lnsorancc Comlreoy Nmo=Ttavek"Pat*"Cas Co of Am
Policy#or Self-con lin t7PJl1BG07SM112 j - RV.W_DaOW19 A/
Job Site Addr. 395
/ ,QV/Jy/✓or1/ (/Y� C"Isw lziw- {/D '
Attach a copy of tiewrbere empessatiom poky deebypti mpage(Adwing the poieymmberadexp6atim date).
Fail=to sere coverage as regrmd under MOL n 15Z§25A is a crii®al violafimpodhabb by afar up to S1,500.00
a,W--y-- g , ,as well as civil penalties in the fom afa STOP'WORK ORDER and a Sae ofup to 5250.00a
day agamsl the vidabe A copy oftbis statetom may be fotwaakdto the Offceoflnvestieations ofthe DLA for imraaoce
coverage verification.
Ido itreij mDJj code - �peavdbes�ptrpy ffiattltei'afmraattiempuvaidrdehmrr' araeadmrra2
5 tmamnc Ilei �l q
Phace#
of)rriatau wlp Mmoftnit im Ma arm.b Ae megrtered l9 d➢alotry allidmf
Ody or Town:_ PerasifOmme#
Esoiab Aw6ordy(circle oaek
L Board of Health 2.BaBdingDeparbownt 3.Cilyffaw Clerk 4 Rkxbiol faspeclor 5.Pmmbi tg h.P ctor
6.Otber
Contact Persaa• Phome tk.
.... . u„�xt`tu -.. ax i`
s ,
... < � ,,.
w -' .. .__ . _. _
�. �, '»
.. .. ,n,.. ., - . : ,.
, .
.. . .p: _.
�.„.... ,. ..+ v,vii.,
.. . .� n
.. .. �bM � � ��
� .
I y . . � . . . .. _r
.. � �. � t� .. .� .�
.. .. r . . _.... ..:f�. . f 11 '
r.�
. � .. 4 Nei. ..
_. . _.. _ _
e.. x �_ >cW ' 73. ., .. .. .
The Commonwealth ofMaswhmetts
Departn¢M oflndsmW&Accidents
I Congress Stre4 Suite 100
Boston,MA 0211¢2017
w gmassgovldio
WWovken'Compeurtim Lamanee AfU"vit Builders/CoatrxbNEkctrivaus/Plombem
TO BE FHFD WITH THE eERbffrnNG AUTHORMY.
Aooliont Information Please Print ieeibly
Name :NRC Construction Inc
Address: 66 Water St Apt 2
City/StatelZip:Ml7fad,Me.01757 Phone#:774 2 8 7-10 85
Are yon re�leper±Clete tae apprapriare tem: Type of project(required):
Lalan.ampl,.m 4 migloYra(fWlmawpa-clue)' 7. ❑New combustion
3❑Dem ride PmarrdmdPrmarh�P and haven eoployta workmgf ax io 5. ❑Remodebng
my® Ay[No wvkma'mmn uewa a rcgw j
3❑Iwa6 aowmdoug dl wkmYsdE(Na uw}mi comp.i�mvse rtgimcd]t 9_ ❑Dcanlition
10,❑Building addition
4.❑I am a twmmvnv mid will behising wntrmeors w rondoct ell swek mmy FrvPmtY. 1 will
nave mal au mrmnms erMbeve wwkm'campmamon mava�a-ewamsole
11.[]Electrical repairs or additions
propricrms win vo emplayeee 11❑Plumbing repairs or additions
5C]Ica a Pd covo-fvravd1have bwel me vb-mamlors IivNmme a�mchcd shed.
Jhew - haw emplolm and Wwwveters'w� �ea: 134DRoofrepain
6.❑We sea mrpm and as offiem Leveemcised meb cute ofvempim pa MGC c 14.001her
15Z 41(a),mdwa havememlaYm.INo weekms'ramp.muam¢Fcgm ]
•AaY aPPtivatmurderksboxpl nun abo fill nisi masecom blow shoxiogmev woheri mmpmastmI bi mfsmacou
t Hommwam who submit thus aadav mdiwtmg theyamdomg dl wwk aN mm hire matlde mmeas mut suhnA a eew eflidavis udr ing sue
:Ca nsemr kth.b .oa aaarLd an addipoml sled showing ft name of de mh<wCforsmd uwe whmhs or ut flueeoe;.bavc
empty Hae�herccmpla ,they mut peovih ticr xvhvs'mmp.pdi"mmbee.
l am me empfoyo lha n promffngwrtns'cont a ation bemrmacefor my engtoyees. Bdow Is tke pad y amijob site
information
Insurance Company Name:Atiantic:
Casualty
Policy#or Self-ms.Lic.0:R2WC947397 Expiration Date:8/1619
Job Site Address: City/State/Zip:
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 a 15Z§25A is a criminal violation pnusbable by a tine up to$1,500.00
and/or one-year imprisonment,as well as civil penalties in the form ofa STOP WORK ORDER and a frac ofup to$250.00 a
day against the violator.A copy ofthis statement may be forwarded to the Office of investigations ofthe DIA for insurance:
coverage verification.
I do herebybyrtthe pains andpenaldes ufperjury tkw.*e mfiwaawa n prowded above is nae andconr
Sianatree: Date:
Phone#. 4-287-1485
Olfiddureonly. Do uolwrifeinthis area,to be conyfdedblcify"town offida(
City or Town: PermittLicemse#
Issuing Authority(circle one):
1.Board of Health 1 Building Department 3.City/rown Clerk 4.Electrical Inspector S.Plumbing Inspector
6.Other
Contact Person: Phone#:
wc�;R CERTIFICATE OF LIABILITY INSURANCE
082W2018
7193 CERTFICATE M bSUEO"A NATTER OF NY0NYATNNI ONLY MID CONFERS NO RIQTTS WON TME CERTI W IIOIDETt T198
CERTIFICATE 006 11(IT AFTTRMATNELY OR NEGA N Y AMBl0,EIDERD OR ALTER TRE COVERAGE AFFORDED BY YNE POLM:MS
BELOW. TH6 CERRFICATE OF INSURANCE OOE6 NOT CONSRfUIE A CONTRACT BETWEEN THE RMING INSURER(S). A�
REPRESENTATNE OR PR CM AND TRE CERTIFICATE VOIDER-
IMPORTANT:
OIDERIMPORTANT: It Ne t r4Rob holder is an AOOIRONAL INSURED,Ne pdicy(leg must M rMw . N 6UBROGADON IS WAPfM.subjwct to
Neterms and cvnENlow dleepula wmmgpdkly mry requYa aneMonemanL Aabbment on Mc ceNllcab tlaes nalmMer rkMsb IM
aen0kab hpitler b NaN otsucb mtlormemengz).
rwN10EwEac Itayti Hddvcsan
ORMSBY INSURANCE AGENCY ver�(l13)TW]-0 a w,:
Anulainsan mn
POEM718 n:anaxM.NIgpis. waw
51'ESf SPPoNGREID NA 01040 s0MAIERA: TRWV RSPROPETTYCASC0OFAM 23W1
wvm
SEXTON ROOFING&SIDING INC
wsuvb:
PO00)(ti32T anuve:
NOLVONE MA OlO0 r:
COVERAGES CETTGI n NUMBER: 280]20 REVISION NUMBER:
THH R TO CHO6Y TINT TE Iq.NE$OF NHMANCE L5f®BELON HAVE BEEN H6UFD TO TIE 9RIITEO NAMED A90YE FOR 1HE POIII.Y FliRDU
NDwAIm. NDIYAMBTANCNG ANY {DIT.TERM OR WNDIIDN OF ANY LOMRACT OR OTHER WCUMEM WITH IEe.PER TO WNIOII TXB
fFRIF1UTE WY BE 13611®pi ANY PERTMN.THE W3URN10E MFOItOEO BY THE POLIOES OE6CN[ND HEAHN IS SIAJECI TO ILL TRE TERN6.
E%GLN6IONS ND WRBITKNB OF8UL11 PoLIOEB.LET6SHgYN IMM INYEBFEH REWCED BY PAD CWM6.
TYROfaYNQ NwYIAwIEII IEI{
f�0Y®w1MtWinY VLMOetlael6 f
CIA.Y.MaE p. i
ueoW i
WA aEWONrLYID✓a41T' {
RNLMGIGRFIIYpIMABRR Cf16W.M01lWlE {
F91w1❑gT �NA NWwIN-mw'.mARp i
wro.a.Aw.nr a
MRMnO BOv.YNM1Y VwPran {
AU Owl® WA •pR .ft a
/i1rn6 Mass.,
MR®MIIO• /Mqa i
is
IaealyAlW �. R fYiIORWOIYf
pvvlaVl M.,wMMepa WA vMlfMrz a
oE0 s
w�tlRM<0�9wATIW X
"^ Wan• Y w
AsmimiomM r wu r•A 0PABIXi0lEB210 00012010 06042019 EL—== f AoOOW1
P1Y�new.rYvl sLaaFAse.a { 1000.000
OEV�INX
us. ELOMFAY-PULYIAD 1860
NN
Oe6Llelipa�[�faeeM�.lug��nl W[Amllrv9ael61ACaIi MI.AO6W RwW atli f4MFeaW NawneM�YwwAy
WaiMers'LongmbWm bWlef0s YA9Oe p{N b MafuNunalls enpbypee anNPUNNMwb Eislwwrlw{WC 200308 B.maWbatralbn is ghen b pry
Gains lar hEYlefilsbenployx¢ in stales aYler than Mecaatlusetls NNia irsueE Nres,br llshM Ylp••wlpg9N auNltle olMasxrheetla.
TNs mY tedbmea:rn slows me wN,Y inI mOc dale Nwlnss rcNidewassR»E(urMV MwD%a0maale on vie aoore PGkY aecetles me
.zw,e tlae da�mervleab9Aarya} The stalusallvsmwape ran ce�tllpRl daavM aaeawglbe PmadcoYcm9e-Cweragevmriaun
Seadi Tad N wAw.nass.gnnwdMonlersmnyerwlbtlw.asEg�vw/.
CERTIFICATE HOIDER CANCELI.ATNON
6NOIIiD lAriFINFABOVEOB01®19l nl C m IN
THE OfPRATDw d1TE TMBEOF. MOIwE Rll E 18NG1® N
AOCOR W NCE NITII THE PO WY PR W I•IQ16
NIIMgI@OIQII®laralM
Demo ,CPCU.wePrattler{-RwNOW iwago-VA']t1BAlA
81930-20tl ACORD CORPORARON. AllrlgM reserved.
AC0R025(2011 i) neACORDnameandig avmgisbvdD soTACORO
�rro CERTIFICATE OF UABIUTY INSURANCE
C6i1FYJRE 669®AS A IIAT W NiAN]t)S a Y AI®aara6 IID Gans ifl'OMl)ta3UFrAYCIwI�I.
IEDOb ND�AFYMNSNBY OR I6TiAl1YaTA6P.W@OOtALYHtTECWBM6EAFF012®6Yi1EP011�BHON
BIIFTJIIE OF IBMAM[t DDB W( COISDIIIIE A awmwcr BEISY®I 4!t 698N6 ROUI�i(Sj.
Ylt'E ai PROa1a3t AMD llt L�AiE 11aL6t
R tlr utiipb bilFisa�ADMtlNILL S6IYr®.Pipoiry(wt�wmt4mbtwd FSIPIWGRl1DN 6 SSAM®.a0jai Ie
wd ra�"vm d 6e petg,mtim Pd�®Y�r endvsvb.A www�WIS wYen Qees nal mlw vjls W
pWtlw'w fw dui
PADp110ER Ynlfu�llgrfYa
6m<LY WomeRRaY.Yc RIQJE F/ix
Po8v Tl8
wea 4WPe6 t�N/1�CDS[PAGE IIIIIL'i
DBP® A: www '>yY{1
SOTm poWjw5Wv9h¢ C
PoHv6ID C
Wlylt,WPipilfl - i1PDtC
S6D�t
P.
' fA1�A('Ei 5 CE�IY�A'11:M11®L fCYN11N�L
�aro moFrnw>�satssas tBPAIIG£Im®�wrlw�e�I mimm'ne�P®w.®IawErmYl�wuerlsaw
POlAl9L HIIMIM-IT1AG/YIY q®IRiEIBIf,1POIOt WIPTDN OF/MY mMIfll1C!DIt OD®1 DOQYENlVY1111 M@FL'fm1YSO1TIB
Wr�s9�as IIn sseaty rIt renixat Inala�eY 1>£sats mc�I+eais9t>�rmtunFYees,
IXa11Qa6NPN101CrS 69GIPDILBII�}59SA•AI WY WNE®Il®11®[IYP11DaAt@
VLLCI H£ IaLIGV
MF MF
L lRE6I6ODE wYo atlLTFPwBt L�
A 10161!@ISP].l VPA19 6®9 BOIDCaIPBi£ SfAm.0p0
x cal9eaaxLr�nl_LUI�nr
a-__lout QomP �moo, 9CO,m0
I®E]OIGM°vI�Y ssaw
ss60xiLawIPSPS 9.u00.at0
nrtaa3snrelAtrusY�peE a�sntw�oe stmcnm
_ r satr � OL¢ snmucr..caFv�wc P,Dnom
ODS3t
. aIISlID9Q®uff ;
Ilx�nT
AxYA11fD DmlYPI1PY�pawy t
MLDNS® 9]S�a® ta1YiDIRYprf t
MI105 /illl0$
If�ADIC6 ��® PMa9iIYDWIfE t
AVIDS
t
IIAB FAai S
IMH YNDE iGaIE6/.lE S
t S
ww�vamPvuw m�iDure
la0i�'IIwiRS YP
lllaR EL FAaIIl.�PIf t
E�III�t IF1
ObLibfblNl 6D ..¢-EA t
FI�LiOebeunwr
a3alICIIDFaSUISFSSebw F;�A�-PoDLYWf t
p®MwY�q$P161ILCI�l1OCIY8GE5IIR®TLIYis1Y�SfY1�Fs ryY Y goMf
CHt1AfAlE Ha➢Ht a1M�l.1DIDN
9dDIYRRTE aB0YEC6®gm£C�e®tID b$aE 11EFAfATB GTE
TG16.F wf16tLEG919®w4¢SwGIL£' MmIl11EMLYAAM9DnS
AUI}IDI��I�ASNE
AaPDB(IDtYO>J (V' � 01985-IDIi AGOflO CaRWNTDN AYrigFGs rtcervE6
rlw ACaA�wme�bgo r�"sMaE®b'.d ACOHD
rr ,
- . ....
1-
a 4
AcioRbr CERTIFICATE OF LIABILITY INSURANCE osHOe
THS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION OILY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOUR THIS
CERTIFICATE DOES NOT AFRRMATIVELY OR NEGATIVELY AMEND, 0 13 OR ALTER THE COVERAGE AFFOROED BY TME POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATNE OR PRODUCER,AND THE CERTIFICATE MOLDER.
NBORTAMT: NIM NrI'S[am I akW ism ADOMO DISUNED,IW poig(rf)n IttYe AMMONAL MURED wmhimrr m beMIdoma&
N SUBROGATION IS WANED,subject m dw rTrte and eo N a dw posy orcin poN•ie am,mqufto NI endaratsrt A at rerN on
thtt rnbi5rm does not coder dglb m tlIe mr4Arar holder in Neu ofsch WKIWSWA Nt(a4
ISABELE CORDEIRO
BFazway Insurance nmrE 97855a91 iNtLiwi,8184659934
345 Win St Unit B1 = ) _tum
Tewksbury MA 01876 Anarmelo xI•ee
eSURSKA:AW"NO 96URANCE CO
euumn
NRC CONSTRUCTION INC wN,NN,e.ATLANTIC CASUALTY MF
Nn•a c:
fib WATER ST APT B -
wN•e o:
MILFORD MA 01757
•6YfBt E:
N911®lF:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
:
THIS IS TO CERTIFY PMT THE POLICIES OF INSURANCE DSTED BELOW IMVE BEEN ISSUED TO TIO=INSURED NAMED ABOVE FOR TRE TIDILY PERIOD
INDICATED. NOTWIIHSTANmNG ANY REWIREMENT,TEAM OR CDNIXIpN OF ANY CpOMCT OR OTHER DOCHENT W(LII RESPCH:T lO 11a11LH THS
CERTIFICATE NAY SE ISSUED OR MAY PERTAIN,THE INSURNfE AFFORDED BY P POLICES DESCRIBED HEREIN IS SUBJECT TO ALL TME TH+MS,
O[CLUSgNSAND CpDTIIONS OF SUCH POLICES.La.9TS SHOVM MAY HAVE BEE!REWLED BY PAID CWMS.
set TTEm RSIWIrG.
FCULIraNlB6t lalf
�/ ai�O.lµGBeNL11ta�11T FALHOfMBNCE fT,DODAN
aAaNNtm❑✓ scan Px a MODO .
L3070002254 018 O111O=21119 r®E✓m 85,000
PBiSC .IVI•YnY 811,000,000
lT)Fl A( tIEFHgfprliH6FBL nB@KMSfH m f 2,000.000
✓ FaICY .ELT ❑ta PAODYCIE-EDeTTMi 82,000.000
OfIB[ f
AYIOYFAII W Wr1 i
NMNRp e'J06YNAlfff 4,nw* 8
TTMDS eME3)IA81 a."OLY ntmllP�vBrq f
1 pLY 40700
+W'05 NRaaIY f
f
Yil UNN �•, N010CaeB•E f
E)O�NW aA•B•MDE IYiEIiTIE a
0® f 8
IreWA54QiB0AlINN ✓
AW aRDY9YIMRIIY _YIN
mF�EYaI®! O ELFILHACC•SIT $11.000.000
NIA
A IN.ar.yr ly R2NTC94T397 0N1fJ2018 08NBD019 ELINff- -FA x11,000,000
•wA re..�
mHimr�lmmB1ATINr6tbr I lsL amAff-PDIILY WT 811,000.000
oacRPnoNmlNBalM•sILOUTwsrvnectas tAwnnwyAr�rlrF.9.arA�.4rrasrEw.ger,rer.q
CAM"ITRY,ROOFING,PAINTING
CERTIFICATE VOIDER CANCELLATION
SEXTON ROOFING 5 SIDING INC sx0un ANY OFTIEANtDVE DFscR89EDPDIAaEs E CAIICB I cn BEFORE
PO BOA 6377 THE EIPINAPON DATE TIFAE(W NOTICE Tel BE DEl1VE1E0 W
ACCORDANCE WRAP£POLFY PPOWgfL4.
1102 PINE ST
HOLYOW MA 01940 Mm a�DRP�B G AR
O 1988-2015 ACORD CORPORATION. AN right re..ed
ACORD M(2016107) The ACORD vane arld logo are regemred marls of ACORD
F.mm�a.y ra6 mss vre sat..�.....se�iaekl my..:w.Herrera TwNWNm
Office of Consumer Affairs and Business Regulation
1000 Washington Street- Suite 710
Boston, Massachusetts 02118
Home Improvement Contractor Registration
Type: Corporation
Registration: 118239
SEXTON ROOFING&SIDING INC Epration: 02/102021
P.O.BOX 6327
HOLYOKE,MA 01001
UpCate Atltlnssr Rehm Cartl.
EVERETI J SEXTON SR HOME IMPROVENGEN 1'cONTdtACTOR
PO BOX 6327 EVERErr J SEXTON SR
HOLYOKE,MA 01041 106%.St
HOLYOKE,M& 0IW(I-2417
SEBTON ROOFING&SWM CO
�IfIMW)
HIGOfi0538i 01/1018 11/30/21119
sx;N® � e
Conor onvmaltti of PAa saxtiu5 tls
Orvision of Regui looal aW Sl rt
6oartl of RYatllrg RegWazions aM 6mIMarEs '
:cns:ruc0on Suxrvsor Speclalfj
CSSL-099689 Expires: IMS2819
PO Box 63V
HOLYOKE MA om01/0'61`0
Cmissioner Cj'