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24A-145 (2) 15 ROE AVE BP-2020-0564 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:24A- 145 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-2020-0564 Proiect# JS-2020-000972 Est.Cost: $52670.00 Fee: $342.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: THOMAS DADMUN 107919 Lot Size(sa.ft.): 20908.80 Owner: MCDERMOTT BRIAN&ZOE PAPPENHEIMER Zoning: URA(100)/ Applicant. THOMAS DADMUN AT. 15 ROE AVE Applicant Address: Phone: Insurance: 60 SCHOOL ST (413) 387-7381 HATFIELDMA01038 ISSUED ON.1111512019 0:00:00 TO PERFORM THE FOLLOWING WORK.-CONVERT GARAGE INTO OFFICE AND BATHROOM 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 11/15/2019 0:00:00 $342.00 212 Main Street,Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2020-0564 APPLICANT/CONTACT PERSON THOMAS DADMUN ADDRESS/PHONE 60 SCHOOL ST HATFIELD (413)387-7381 N/•�� �'� ' P�-AN PROPERTY LOCATION 15 ROE AVE 1, c� MAP 24A PARCEL 145 001 ZONE URA(100)/ �'0�' THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST CLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid _ Typeof Construction:_CONVERT GARACE111VO OFFICE AND BATHROOM T New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 107919 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF RMATION 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: 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 Tim Si ature&ofBuilding Official 10 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. Con vivG9'u6P-,.).0 -6-0- V Department use only City of Northampton Status of Permit: �-7- Building Department Curb Cut/Driveway Permit J � 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,ALTER, RE AIR, &FAIEM VPE I A O E OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION a 14 l 1.1 Property Address: ' his ecti n to be completed by office �o�, DEPTOF6 Lot Unit NORTHAMPTON.MA 01060 � og"Kp1- W, HA 01060 Overlay District 1 l Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name(Print) Current Mailing Address: Telephone _ Signature 117 ^5 2.2 Authorized Agent: �0 ��, �u�. HA 0!038 Name(Pri t Current Mailing Address: Signature Telephone SECTION 3 -ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building ;47 ` 050,0 V (a)Building Permit Fee 2. Electrical 4 uo (b)Estimated Total Cost of 1 Construction from 6 3. Plumbing 1'`�5a °4 Building Permit Fee 4. Mechanical (HVAC) Zl�so. 5. Fire Protection 6. Total=(1 +2+3+4+5) 5 Z (Q`(0 ,„v Check Number 1303 This Section For Official Use Only Building Permit Number: Date Issued: Signature: I l Building Commissioner/Inspector of Buildings Date -6V @ LOVAJ IN VIA EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information 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 Parking Spaces Fill: volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO O DON'T KNOW 0 YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO ® DON'T KNOW © YES IF YES: enter Book Page and/or Document # B. Does the site contain a brook, body of water or wetlands? NO ® DON'T KNOW (D YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained ® , Date Issued: C. Do any signs exist on the property? YES NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES ® NO IF YES, describe size, type and location: E. 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 ® NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) 7Roofing ❑ Or Doors D Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks Siding [0] Other[CI] Brief Description of Proposed /� Work: ri0►.yu-T 6[`�W& 619 L(arc.lA k&JW10 10 62 0 Ff`[G l� � r AT14 'Ivo wl Alteration of existing bedroom Yes--,X—No Adding new bedroom Yes _ No Attached Narrative Renovating unfinished basement Yes Q No Plans Attached Roll -Sheet 6a.If 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? J L'6 d. Proposed Square footage of new construction. Dimensions e. Number of stories? L 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 ft.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 O,R CONTRACTOR APPLIES FOR BUILDING PERMIT }� I, " lArk-r �'\LV' twZ ,t 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 of Owner Date p Lp I kd, 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. Print Name Signature of O ner/Agent Dat SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: 1 Not Applicable ❑ Name of License Holder: 6Ct"1^�1 �G �f �lyT✓ uJ It I q 1 I 1 Q LicenseNu ber eo2 M ofobi Z 4I /2,oz l Addre Expiration Date Zo�� �C_j 41 Signature Telephone 9.Registered Home Improvement Contractor: Not Applicable ❑ -tom, i1u-m2 Gkuw,u-, 11 %0, Company Name Registration Number �0 5 u-L , 1kj,0, VIA 610ab b12� 12,o7,v Address Expiration Date Telephone 1 ZJ-27—73b( SECTION 10-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....... No...... ❑ City of Northampton Massachusetts �.f DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building Northampton, MA 01060 �w 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 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 pre-existing owner-occupied 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 Type of Work: I lz—w a,,(&Rw Est. Cost: Address of Work: �`7 �t:r,-AJ E Date of Permit Application: l u I Zj o I Zo I 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 for a building permit as the agent of the owner: lokolLvlj -TOA%06 V,- bW)i&� 1- 0° n- Date Contractor Name 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 zr � DEPARTMENT OF BUILDING INSPECTIONS �s x tJ �" 212 Main Street *Municipal Building y � Northampton, MA 01060 ssbiy 11a 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 properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A. The debris from construction work being performed at: (5 Fil AV (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: k5-00'S �J7APSV,�� (Company Name and Address) �L�j, 0/J4,11A,— ?J c 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. The Commonwealth of Massachusetts Department of Industrial Accidents a I 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 Le��ibly Name (Business/Organization/Individual): 7"W1,,p DFivLt !� 1'R+Vtho,t� Address: 5D, City/State/Zip: i t % fAA 010U Phone #: Are you an employer?Check the appropriate box: Type of project(required): 1.❑I am a employer with employees(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.[No workers'comp.insurance required.] 9. Demolition 3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10❑Building addition 4.❑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 l I. Electrical repairs or additions proprietors with no employees. 12.�Plumbing repairs or additions . 5.0I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13 []Roof Plum rep airs These sub-contractors have employees and have workers'comp.insurance.] 6.❑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.] *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. tContractors 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. an;an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: 1 Job Site Address: I5 �- City/State/Zip: N N N, o Attach a copy of the workers'compensation policy declaration page(showing the policy number and expirath no 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 pains d penalties of perjury that the information providedf above is true and correct. Signature: Date: Phone# Official use only. Do not write in this area,to be completed by city or town offieiaL 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 C o nstrvCfitg1'tupgry i s or CS-107919 L:�cpires:09124E2021 THOMAS DADMUN 60 SCHOOL ST HATFIELD MA 09038 Commissioner J Office of Consumer Affairs and Business Regulation 1000 Washington Street Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: LLC Registration: 179682 THE TUCKER GROUP LLC. * Expiration: 08/27/2020 so SCHOOL ST HATFIELD,MA 01038 Fw Update Address and Return Card. SCA t A 20M-05/17 �i�ir`l�n,�nr.mar+rl/�n�"',lr/aauic�i.�r(I,s Office of Consumer Affairs 8 Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE: LLC before the expiration date. If found return to: Reciistration Expiration Office of Consumer Affairs and Business Regulation 175682 08:2721720 1000 Washington Street-Suite 710 THE TUCKER GROUP LLC. Boston,MA 02118 THOMAS DADMUN 60 SCHOOL ST ' HATFIELD,MA 01038 Undersecretary Not valid without signature ACC>R"� DATE IMM/DDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 11/zs/zota 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 Susan Fleury,CIC,CISR, NAME: King&Cushman inc PHONE (413)584-5610 (413)584-9322 E-MAIL _IA/C. ck '�No Ext: tAK N _ P.O.Box 447 ADDRIESS: sfleury@kingcushman.com 176 King Street INSURER(S)AFFORDING COVERAGE NAIC 0 Northampton MA 01061 INSURER A: Main Street America Assurance Co. 29939 _ _............,,,_._,._._.__..___._........ --- INSURED INSURER a DADMUN DESIGN&CONSTRUCTION INSURERC: 60 SCHOOL ST INSURERD: INSURER E: HATFIELD MA 01038-9747 INSURERD: COVERAGES CERTIFICATE NUMBER: CL18112602970 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. INSIR .._......._....._._......_......__..___..._...._,_,.__.._.._.., R ._ F - POLICY POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDD/YYYY (MMIODIYYYY LIMITS X1 COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1.000,000 -DAVAG=-RE 500,000 CLAIMS-MADE �OCCUR PREMISES IEa occurrence S MED EXP(Any one person) $ 10,000 A MPT4694Q 11/13/2018 11/13/2019 PERSONAL&ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: F GENERAL AGGREGATE, y 2,000,000 rt��--1�PRO- 2,000,000 POLICY u JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: Identity Recovery $ 25,000 AUTOMOBILE LIABILITY Ea BINEMSINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) S OWNED SCHEDULED BODILY INJURY(Per accident) E AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY eraccld"t $ UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEC) RETENTION S $ WORKERS COMPENSATION R EOTH- R AND EMPLOYERS'LIABILITY YIN ,STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE I E.L.EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? NIA (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached It more space Is requlred) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORO 25(2016103) The ACORD name and logo are registered marks of ACORD DADMUN Design + Construction Prosect Address: SubContractor List 15 Roe Ave. 31-Oct-19 Northampton, MA 01060 Subcontractor: Has Employees: Yes No Wallace Plumbing and Heating X James Elkins Electrician X Brian Polan X Bill Longridge X SDL Home Improvement X Right Way Drywall X Cortina Tile X Dion Flooring X Executive Painting X A� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 10/31/2019 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 Caitlyn Elliott NAME: Encharter-MA A/°No Ext): (800)675-6695 FAX No): (800)754-1602 Encharter Insurance LLC E-MAIL celliott@encharter.com ADDRESS: 25 University Drive INSURER(S)AFFORDING COVERAGE NAIC M Amherst MA 01002 INSURERA: Travelers Cas&Surety of IL 19046 INSURED INSURER B: Jason Wallace INSURER C: 312 Main Rd INSURER D: INSURER E: GIII MA 01354 INSURER F COVERAGES CERTIFICATE NUMBER: 2019-2020 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 AL1ULbUt1H1 POLICY EFF POLICY E P LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTE_7 CLAIMS-MADE Fx_]OCCUR PREMISES Ea occurrence $ 300,000 MED EXP(Any one person) $ 5,000 A 680-3E561935-19-42 02/27/2019 02/27/2020 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER'. GENERALAGGREGATE $ 2,000,000 X POLICY ❑PRO- LOC PRODUCTS-COMP/OPAGG $ 2.000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANYAUTO BODILY INJURY(Per person) $ 100,000 A OWNED SCHEDULED BA-7G304126-19-SEL 01/22/2019 01/22/2020 BODILY INJURY(Per accident) $ 300,000 AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident Uninsured motorist BI $ UMBRELLA LIAB �r OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION I PER OTH- AND EMPLOYERS'LIABILITY y I N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ NIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Dadmun Design and Construction ACCORDANCE WITH THE POLICY PROVISIONS. 60 School Street AUTHORIZED REPRESENTATIVE Hatfield MA 01038 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD DATE(MMIDD/YYYY) ACORO® CERTIFICATE OF LIABILITY INSURANCE 07/17/18 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 NAME: Bresnahan Insurance Agency,In ANON o Ext: 413-536-0536 A/c No: 413-534-4291 100 Whiting Farms Road E-MA Holyoke,MA 01040 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC p INSURER A: Mapfre/Commerce Insurance CO. INSURED INSURER B James Elkins INSURER C 2 Williams Street INSURER D Holyoke,MA 01040 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 CONTRACTOR 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. LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE rx-1 Ea OCCUR PREMISES occurrence) $ MED EXP(Any oneperson) $ 5,000 A 8008030003716 05/05/18 05/05/19 PERSONAL&ADV INJURY $ GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY ECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMB—INT57INCLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPER $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDRETENTION$ $ WORKERS COMPENSATION I PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE❑ N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Electrician CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Dadmun Design&Construction ACCORDANCE WITH THE POLICY PROVISIONS. 60 School St. Hatfield,MA 01038 AUTHORIZED PRESENTATIVE NIP:,• , ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD � ` DATE(MMIDD/YYYY) C" Li CERTIFICATE OF LIABILITY INSURANCElllb�­ F 06/24/19 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 NAME: Karina Linares Dale A Frank Insurance Agency,Inc. A/cCNxto E : 413-665-8324 A/C No: 413-665-1280 PO Box 455 F-MAIL s: info@DaleFranklnsurance.com Sunderland,MA 01375 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Main Street America INSURED INSURER B: Brian Polan INSURER C: 175 Russell St INSURER D: Sunderland,MA 01375 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. LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DDY/YYYY EFF MMIDDIYYYY Y EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE:TO RFNI ED CLAIMS-MADE FlOCCUR PREMISES Ea occurrence $ 500,000 MED EXP(Any oneperson) $ 10,000 A MPP0949K 11/05/18 11/05/19 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 POLICY 1:1 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATIONOT AND EMPLOYERS'LIABILITY Y/N STATUTE ER H ANY PROPRIETOR/PARTNER/EXECUTIVE❑ NIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Tom Dadnum ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Karina Linares ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD _t ..,_...r,. .. _ ._. ._.d.. � .. J - .1 a .. .. S ' f i .. .,wn. .. - M y. �<_..r.sl...+I.' a .-i a .w _ � �.y.. ...x. .. � -...- .+ .. .��- .. �+Ms��+rsrrwnsa��rV*�.aNr�n. r .e i,........ r/ .. � �. ® DATE(MM/DDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 10/31/2019 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 MSA Service Center NAME: Encharter Ins LLC CL SC PAHONrE o.Ext, (866)415-5391 pIC,No: (866)332-4776 MSA Service Center E-MAIL servicecenter@msagroup.com ADDRESS: PO BOX 2006 INSURER(S)AFFORDING COVERAGE NAI C# Keene NH 03431 INSURER A: Main Street America Assurance 29939 INSURED INSURER B; i Bill Longridge INSURER C: PO BOX 88 INSURER D: INSURER E: Belchertown MA 01007-0088 INSURER F: COVERAGES CERTIFICATE NUMBER: 18-19 Master 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 AUDIL Z11.16K POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSD WVD POLICYNUMBER (MM/DD/YYYY (MMIDDIYWY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO R CLAIMS-MADE ®OCCUR PREMISES(Ea occurrence) $ 500,000 } MED EXP(Any one person) $ 10,000 A MPT2736M 12/26/2018 12/26i2019 PERSONAL&ADV INJURY $ 1,000,000 t 2,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ t X POLICY F PRO F LOC - PRODUCTS-COMP/OPAGG g 2,000,000 JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANYAUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH - ANDEMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N IA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ .t DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) I of CERTIFICATE HOLDER CANCELLATION I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE i1 THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Tom Dadmun ACCORDANCE WITH THE POLICY PROVISIONS. 60 School Street AUTHORIZED REPRESENTATIVE Hatfield MIA 01038 l ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and iogo are registered marks of ACORD A IDATE( MoDiYYYY) ACC)'REf CERTIFICATE OF LIABILITY INSURANCE x,03;2099 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 INSUREIR(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT* If the certificate holder is an ADDITIONAL INSURED,the policy(les)most 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 eights to the certificate holder in lieu of such endorsement(s). PRODUCERCONT Cynd*Henderson CISR,CPIA NAME: FAX Webber&Grinnell PHONE (413)586-0111 �,,� (413)586-6461 14 116 ,N9.ext): I I" 6 North King Street ADDRESS:MAIL cheridersonawebberandgrinneltoorn INSURER(S)AFFORDING COVERAGE N IC to Northampton MA 01060 INSURER A: Set Ins Co of S Carolina 19259 INSURED INSURERS: Selective Ins CO of Southeast 3$926 SDL Home Improvement Contractors.Inc. INSURER C; 24 Chestnut Street INSURER 0: INSURER E: HatfieAd MA 01038 INSURER F COVERAGES CERTIFICATE NUMBER: Master Exp 2020 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 I ADDI: POUCY EXP LIR TYPE OF INSURANCE I WV 1) POUCYNUMSE-A (MMAX)IYYYYL LIMITS X COMMERCIAL GENERAL.UABILITY EACH OCCURRENCE S -54MM-MIONTED 500,000 PREMISES(ft 640#Mr") S — CLAIMS-MADE MED EXP(Any of*person) S 15,000 A — 52291509 0110112019 0110112()20 PERSONAL I All 11,WRY S 1,000,000 GEN L AGGREGATE LIMIT APPLIES PER GENERALAGGREGATE $ 3.000,000 - 0 3,000,000 POLICY E-1 PFIcOT Loc, PROMCTS-COMPIOP AGG S ROTHER $ 0(')MONED SINGLE LIMIT S 1,000,000 AUTOMOSILE LIABILITY (E a wx'kifint) ANYAUTO BOMI,Y iNJURY(Pt-1 persm) 5 A OWNED r;Z3 SCHEDULED A9105420 0110112019 0110112020 BODILY INJURY(FW arc d"it) S AUTOS ONLY I IfN AUTOS HIRED NON-OVMEO PPOPERTY DAMAGE S AUTOS ONLY AUTOS ONLY -ffltJKcid6r>n - Underinsured motorist BI s 100,000 X UMBRELLA LIAR OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAS CtAiMS-MADE S2291509 0110112019 01101/2020 AGGREGATE $ 1,000,000 DEG I RETENTION$ — WORKERS COMPENSATION - X PS1111TUTE I;-;zN;l EOR AND EMPLOYERS'LIASILITY YIN 500,000 OFFICER,,'MEM'SER EXCLUDED? B ANY PROPRIETOR,'P.�R.TNr:R,EXECUTIVE NIA WC9024456 02123=19 02J2312020 E.L.EACH ACCIDENT $ F 500,000 7Y E L DISEASE-E"A EMPLOYEE S (Mandatory in NM) It yes,oesailm un(w DISEASE-POLICY LIMIT s 500,000 DESCRIPTION OF OPERATIONS beio. E.L. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional R#014"SChoduW MOY Lis J1WWJ*d it MOM spwo is required) The Workers Compensation policy does not include coverage for Paul Schmidt,Kendrick Dempsey and Douglas Schmidt. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN DADMUN Design+Construction ACCORDANCE WITH THE POLICY PROVISIONS, 60 school street AUTHORIZED REPRESENTATIVE MA 0,11038 Hatfield 4+- 1988-2015 -1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25120116M) The ACORD name and logo are registered marks of ACORD Aco CERTIFICATE OF LIABILITY INSURANCE 77YYYY) /3/17 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 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 NAME:CONTACT Matthew Brown Dale A Frank Insurance Agency, PHONE FAx -1280 Exn (413) 665-8324 11 No; (413) 665 PO Box 455 E-MAIL ADDRESS: info@DaleFrankInsurance.com Sunderland, MA 01375 INSURER(S)AFFORDING COVERAGE _NAIC# INSURER A:Providence INSURED INSURER B:PrOCIreSSiVe Rightway Drywall Inc. INSURER C:Guard Brian Johnson INSURERD: 206 Coles Meadow Road INSURER E: Northampton, MA 01060-1111 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. IEXP LTR TYPE OF INSURANCE INSR W D POLICY NUMBER MIMIY% IPNID�DrYYYY LIMITS A GENERAL LIABILITY BOP0093210 1/15/17 1/15/18 EACH OCCURRENCE $ 1 000,000 X COMMERCIAL GENERAL LIABILITY PREMISES DAMAGE (Ea occurrence)RENTED $ 50,000 CLAIMS-MADE E_1 OOCUR MED EXP(Ary one person) $ JB 000 PERSONAL&ADV INJURY $ 11000,000 GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATE LIMITAPPLIES PER PRODUCTS-OOMP/OPAGG $ 2,000,000 POLICY F PRO- LOC g B AUTOMOBILE LIABIUTY 02849700-1 1 1/26/17 1/26/18 , NdaaDISINGLELIMIT $ ANY AUTO BODILY INJURY(Per person) $ ALLOWPED SCHEDULED BODILY INJURY(Per accident) $ 500,000 AUTOS AUTOS NON-OWNED PReOP tleYDAMAGE $ HIREDAUTOS _AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ 3/8/17 3/8/18 W'YSTATU- $ R2WC8 C WRKERS COMPENSATION r AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT $ 100,000 OFFICE RIME MEER I LIDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yyes,describe under DESCRIPTIONOFOPERATIONS below E.L.DISEASE-POLICY LIMIT 1 $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is regui red) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Tom Dadmun ACCORDANCE WITH THE POLICY PROVISIONS. 60 School St Hatfield, MA 01038 AUTHORIZED REPRESENTATIVE Matthew Brown © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The AC ORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: Client#: 41601 CORT11 ACORD,, CERTIFICATE OF LIABILITY INSURANCE 1 DATE04/16/2016120,Y9 19 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 WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Man/A.Henderson People's United Ins.Agency MA PHONE 413 781-6871 844 645-1330 AIC No El): A/C No One Monarch Place, 10th Floor E-MAIL enerson eo ADDRESS: Ma ryHd@ples.com P PO Box 4950 INSURERS)AFFORDING COVERAGE NAIC N Springfield, MA 01144 INSURER A:Merchants Mutual Insurance Co 23329 INSURED INSURER B: Cortina Tile of West Springfield INSURER C 1645 Riverdale Street INSURER D West Springfield, MA 01089 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 CONTRACTOR 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 EFF POLICY EXP LTR N WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY BOP1071849 3/30/2019 03/3012020 EEAACMHAGOEC7C'U.RR�RENCE $110001000 CLAIMS-MADE a PREMISES EaOCCUR EoNTEDnce $500 OOO X Blkt Al Per Prior MED EXP(Any one person) s6,000 Written Contract PERSONAL s ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: I GENERAL AGGREGATE $2,000,000 C LOC PRODUCTS $2,000,000 POLICY a JE OTHER: $ ACOMBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea accident $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY A X UMBRELLA UAB X OCCUR CUP9146566 0313012019 03130/2020 EACH OCCURRENCE $11,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $11,000,000 DED I X RETENTION$10000 __ $ A WORKERS COMPENSATION WCA1033448 3130/2019 0313012020 X 1,7,TATtrrFI IrRoTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/ExECUTIVE YIN E.L.EACH ACCIDENT $500,000 OFFICER/MEMBER EXCLUDED? a N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Blanket Additional Insured per Merchants form MU8277(1111); Blanket Additional Insured-Completed Operations per Merchants form MU8530(1111). Proof of Insurance CERTIFICATE HOLDER CANCELLATION DADMUN Design+ Construction SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE g THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Tom Dadmun ACCORDANCE WITH THE POLICY PROVISIONS. 60 School Street Hatfield, MA 01038 AUTHORIZED REPRESENTATIVE &"dju OAR4& ± ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) 1 of 1 The ACORD name and logo are registered marks of ACORD #S1081057/M1081053 MADCT AC�® DATE IMM/DDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 10/31/2019 1114�THIS CERTIFICATE IS ISSUED ASA 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 Barbara Grynkiewicz NAME: Webber&Grinnell AICNE Ext: (413)586-0111 Fac,No: (413)586-6481 8 North King Street E-MAIL SS, bgrynkiewicz@webberandgrinnell.com ADDRE INSURER(S)AFFORDING COVERAGE NAIC p Northampton MA 01060 INSURERA: Patrons Mutual Ins.Co.of CT 149235 INSURED INSURER B: State Auto Property&Casualty Ins.Co. 25127 A.Dion&Son Floor Contractors,LLC INSURER C: Attn:Donald&Daren Dion INSURER D: P.O.Box 656 INSURER E: Hadley MA 01035 INSURER F COVERAGES CERTIFICATE NUMBER: Exp 7/1/20 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 AUULIbUtill POLICY EFF POLICY EXP LIMITS LTR TY PE OF INSURANCE INSD WVD POLICYNUMBER MM/DDIYYYY MMIDDIYYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED_7 CLAIMS-MADE Fx_1 OCCUR PREMISES Ea occurrence $ 300,000 MED EXP(Any one person) $ 5,000 A BOP2806463 07/01/2019 07/01/2020 PERSONAL&ADV INJURY $ 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY ❑X JECT �LOC PRODUCTS-COMP/OP AGG $ 4,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident ANY AUTO BODILY INJURY(Per person) $ A OWNED X SCHEDULED BAP2406132 07/01/2019 07/01/2020 BODILY INJURY(Per accident) $ AUTOS ONLY /� AUTOS X HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY X AUTOS ONLY Per accident X 19 PIP-Basic $ 8,000 X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 2,000,000 A EXCESS LIAB CLAIMS-MADE CXS2125771 07/01/2019 07/01/2020 AGGREGATE $ DED I I RETENTION$ PER $ WORKERS COMPENSATION X1 STATUTE EORH AND EMPLOYERS'LIABILITY Y/N 1,000,000 B ANY PROPRIETOR/PARTNER/EXECUTIVE NIA WCP2227689 07/01/2019 07/01/2020 E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Dadmun Design&Construction ACCORDANCE WITH THE POLICY PROVISIONS. 60 School Street AUTHORIZED REPRESENTATIVE Hatfield MA 01038 bi/l -D 1 _4 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD INGRAMJO01 MMILLS ACORO' CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 12/15/2017 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 Melissa L Mills NAME: The Jarrett A ency g PHONE 657 Enfield Street (A/C,No,Ext):(860)745-4222 (FAX VC,No):(860)741-6901 Enfield,CT 06082 EbDAR'E :melissa@thejarreftagency.com INSURERS AFFORDING COVERAGE NAIC 0 INSURER A:Main Street America Assurance Company 29939 INSURED INSURER B:NGM Insurance Company 14788 Executive Painting and Wall Covering LLC INSURER C: 10 South Road INSURER D: Enfield,CT 06082 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 POLICYMIL IYYYY EFF POLICY EXPLTIR LIMITS A COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE �OCCUR MPT7137P 08/22/2017 08/22/2018 DAMAGE TO RENTED 500,000 ccu rence $ X BOP MED EXP(Any oneperson) $ 10,000 PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑jE& E LOC PRODUCTS-COMP/OP AGG 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO BODILY INJURY Perperson) $ OWNED SCHEDULED AURTEO$ONLY AUTOS BODILY BO�DILY INJURY Per accident $ AUTOS ONLY AUTO ONLY PPeoacEciden DAMAGE $ B X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE CUT7137P 08/22/2017 08/22/2018 AGGREGATE $ 1,000,000 DED I X I RETENTION$ 10,000 WORKERS COMPENSATION PER ISTATUTE ERH- AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACH ACCIDENT $ WFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Dadmun Design&Construction THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 9 ACCORDANCE WITH THE POLICY PROVISIONS. 60 School St Hatfield,MA 01038 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD From:Jonathan Flagg [mailto:jflagg@northamptonma.gov] Sent:Thursday, November 07, 2019 4:01 PM To:Thomas Dadmun; Louis Hasbrouck; Kevin Ross Subject: 15 Roe Ave. Good afternoon Tom, I am in the process of reviewing your building permit application for the project at 15 Roe Avenue, and I will need a little more information. 1.We will need a plot plan of the property. Please see attached. 2.A spec. sheet for the window in the bathroom (because of its close proximity to the shower, it will need to be "Tempered") w4xiow by Maivin. .27 U-Factor, .30 SHIGC.Casement style window and yes, it will bel I'll provide a spec sheet when the unit is ordered. 3. What will the finish ceiling height be? f 4. the insulation value for the ceiling should bEJM., (you have listed an R-38).JW'? i i i i i GARAGE 1 F'-0" 15 ROE AVE. NORTHAMPTON, MA 92.1 S'