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30B-022 (11) 221 RIVERSIDE DR BP-2020-1171 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 30B-022 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ROOF BUILDING PERMIT Permit# BP-2020-1171 Proiect# JS-2020-001975 Est.Cost: $12300.00 Fee: $100.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor., License: Use Group: SEXTON ROOFING CO 99689 Lot Size(sq. ft.): 45302.40 Owner: NONOTUCK COMMUNITY SCHOOL INC. Zoning,: URB(100)/ Applicant: SEXTON ROOFING CO AT. 221 RIVERSIDE DR Applicant Address: Phone: Insttrttt ce: P O BOX 6327 (413) 534-1234 W(' HOLYOKEMA01041 ISSUED ON:5/27/2020 0:00:00 TO PERFORM THE FOLLOWING WORK.-STRIP & SHINGLE 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 Signature: FeeType: Date Paid: Amount: Building 5/27/2020 0:00:00 $100.00 212 Main Street, Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner Versionl.7 Commercial Building Permit May 15,2000 c Department use only �� .,`.✓S I ',+f City of Northampton Status of Permit: j Building Department Curb Cut/Driveway Permit - MAY 2 G 212 Main Street Sewer/Septic Availability� u ROOM 100 Water/Well Availability Northampton, MA 01060 Two Sets of Structural Plans OF BUILDING INSPECTK iphone 413-587-1240 Fax 413-587-1272 Plot/Site Plans 'THAMPTON.MA01060 •-- Other Specify APPLICATION TO CONSTRUCT,REPAIR, RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office � n� 2Map Lot Q��-- Unit 21 / Zone Overlay District L Elm St District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner,onf�Record: 221 116 'Q f1uL C�717atc Vr �� cc . , a ✓ Name(Print) Current Mailing Address: Signatur K ( Telephone 2.2 Authorized Agent: ( / \ (� / �6 -3d-7 ���Ya � U"4 o(o�(i Name(Print) Current Mailing Address: .SAY - /Z3 � Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building l (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=0 +2+3+4+5) Check Number This Section For Official Use Only Building Permit Number Date 3 aO —71 Issued SignatureIle / 5- Z-7-2v Building ommissioner/Inspector of Buildings Date viCu CD�SI l<u c i I 0 w (&OZ- F04M -k 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 Walt Signs ❑ Demolition❑ Repairs❑ Additions ❑ Accessory Building❑ Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing 9. Change of Use❑ Other ❑ Brief Description Enter a brief description here. Of Proposed Work: / � 1 n'5 c �,"1( 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 ❑ 113 ❑ B Business ❑ 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 ❑ 513 ❑ U Utility ❑ Specify: M Mixed Use ❑ Specify: S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE Existing Use Group: Proposed Use Group: 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(so 1St 1st 2nd 2nd 3 rd 3rd 4m 4m Total Area(sf) Total Proposed New Construction(sf) Total Height(ft) Total Height ft 7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone[:] Municipal ❑ On site disposal system❑ _ f ., i ;• !i c�fir; `V� t'w�'}Cr t�•41'' (� on '-'. %.» f Y,rf+C}i2 i:�* s}t1�%�;°'W f 1 •. , q,E, ��' �'&a � .#'. � ':,,}} � t`i't.4• >tr .'9b_ f y S't��g T Yz=e �i R :t ' i.. .. i� qi;<��'Si,rE'�"3"s �,`.'. '.P•,.'it'� �'..;rid; � � ' .•.t d 1. , IC r ... t tr1 - s . a At, - „i:,�:t}, ...:.... ..,' %:e- e..'.-.:.° ><t.. _ :>.' %P �?'.rg, t+r....i._ �'fl's 1'�x� ..r-r'7'. ;'�1.,'' 4i"� .. ,..'��. S1. Y4 �•"Tk_ 1-3 t s r f y s' .0 i r� •r t, r f '.r;a +i>?. a ru?-y"1 t �r af,tt" �1 XC,i" F , � , #i y '1 ;400 P x 'r1 f`'s �ttr:ii ' ' i r�rrji �E�;:.i,.'.}..I;t:n 1 !�. �4tL�'.l�i�t' ,f ;:i'�"f'� f•,.� «,z+ �r°`a`i?iif'� '`a?Fif`i.,,, ^i`'�.�}tE''�'9t _._1 `� � �SaE'�€'.4';:.i<a.....� .� -77 oft r i Version 1.7 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: f Rear Building Height Bldg. Square Footage % Open Space Footage /... ;_.._. % (Lot area minus bldg&paved 1 parking) #of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Varian Finding ever been issued for/on the site? NO O DONT OW O YES O IF YES, date issued: IF YES: Was the permit r orded at the istry of Deeds? NO O DONT KNOW YES O IF YES: enter ook Page and/or Document # B. Does the site contaip a brook, body of water or Hands? NO O DONT KNOW O YES O IF YES, has a pefmit been or need to be obtaine rom the Conservation Commission? Needs to be obtained O Obtained , Date Issued: C. Do any signs exist on the property? YES O NO O IF YES, de cribe size, type and location: D. Are there ny proposed changes to or additions of signs intended for the property? YES O NO O IF YES, describe size, type and location: E. Will the construction activity disturb(clearing, grading, excavation, or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES O NO O IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Versionl.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: Not Applicable Name(Registrant): Registration Number Address Expiration Date Signature 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 / � X 0/16d�� t 1 j- ��c�(`�`� �,"—.� Not Applicable❑ Com ny Name: 04,14 j Re risible In Charge of Construction Address 53Y�z 3 y Signature Telephone F Pf77 ,5 -_._..- .... . .. ... .. .�. ,,....,.,,��x.,_.:��........:. _. . -..,.•..;,.„•war,..-«- ,r - ._ .,,. , r.w��... ...y.;. ,au..w.:.,. _ 4a.. .. .. - w4 joy1 cel F� Ot1'At9� 'iv Z � { i4�/•bw.R C;Pi 0 :4;,y '. .� _.., n %Y_ _ ^5' +l .. ..J» ......._ .. y«_.. • .. -.a_,.....wW... r_.....,•._`.a,....._.. a f .Lad'! ' y, /i�rl `_J y++� c i°�'!'�. �iQLt � 3 .::'. G• `. int.` t :SSL "MM V ,,Y y. ' t•�F 1t: i {.r. t;f:` >;'"•a_i a ../ . i �- :.ini,^.. t:.,e,... 1 y t�.r. i,. 1 '•� .fl. �;.. i '1\ Y, �' f �.• .,'. 't I t G ^7 R¢�iP La!`y- 1,R�4 ���•SR J.�: r 'u.'�.IG 'a' �:� +aYa ` r 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 O No SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner of the subject property hereby authorize `�Q�[--�-�r..l \ C�r` l d J �C l ,c 1 GL�- to T act on my behalf, in all matters relative to work authorized by this building permit application. a'. /46, �(-., s /z, I zC, Signature of Owner Date 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 p i s and penalties of perjury. Print Name 1 Signature of Owner/Agent Dat SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supe isor: Not Applicable ❑ Name of License Holder: `e/z 0 / ' License Number fc) - ( l 0,% Pjr 29F9 Address Expiration Date ��� Y 2 - AD & 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 buildi g permit. Signed Affidavit Attached Yes No O i rif£+ :t�R,-: '1,`� ;#i +'i..t'- �ivg .., r ..,J,�...« . ...... ..c.,,,a,,,,,-... ._ ..__ ...._..._,�..._,»i ,.. •...».... .a�..-l. ,,,�. _. .,:q�.. ,Il&, `•71 ti...`d'•t .. ;7. T 'i`r':r1, •t :lit. w ,:.ti�'y �K�. 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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: -7),2 . The debris will be transported b P Y The debris will be received by: Building permit number: Name of Permit Applicant 5 2� Date Signature of Permit Applicant SEXTON ROOFING AND SIDING INC w�►�.xt1�[vvflrlt.cvm P.O. Box 6127 %Waft** llnlwt►kt. MA OID41 411.511.1214 f. +111,S ly.�►w0y► MA NIC 0 11&233 1 PH(V t Oil 3117 wrn n n 4,6'" Mi I t U 1 RhV"A& 1*+ !1►�hAMT 1'�►r Qrw MeM _. 011 S1 r t1,r1r VIM V, %U It 10 1 IVA tl('V%4 V XIt1h2111*14'C.lit OfON SIIW1I8tiTt'(VICAit MAM)/SIFIMAr1SFYM. 1) Srnfyp ad ntal vc exuttalt shinaks ad dispose of in proper ladfill. 2) lapny room deet wd m►lom M weeded•a SKOD pct c1lert. (Add S.5,000.00 if all new 6.needed) 1) Im aill rw tetra[e44*&to niers ad eaves of nail. (11,") d) Ilrtti1 kV ad water sfWMY 08 eaves(A'), vent stach, in r allem rtuenart, and al Mntrrw"inx roo(s. t) im ill M IS aymtfirtic roo&M Ich on rrmaider of mol. 61 laiarall■ ar Affirps wet e:imiryt vent aacin. 7) imhlli starlet terra on laves ad ralccs of mal. 111 lirMO iKO ArdMkvtrtrnl Mthle roofigt sltiodles as pct mmmiacturcn* %pm-truarionn. P) Iowa aro c►nlrlm t1atft on chimimev. 10)imitiiil ata tap tnar fu r vm. 11)gty I LNrtitor wu n no mW SRC 1 n, worltmaesh►p wanamr. ilr lleilrlwalr Mea!'•a�wllM•ara+rMnw nAa w r..•�r.calc.n..w M me 04WWC d4 ftNftJaoww/I&"MMOM.&* AM MAS 44* M TVfIV rV TO Of IMAM AS/04 OMS." _ dart in InN upas eompoetlott M Mlt!alr llmAld AM MSA M k.uM�pMwN M! Amakmijed __-. _.. AUMAT 0000 AM V*wd R,RMMOMM Itw+,W" AR%AMl*MM.r '. *WOW 000 Abaw VWAOMMM a-A*w4 r%a!AIM,*A k f%m umd m% +'w'�"` /� -"•"t...�.. L� 4*r wfl dmww A"aA bomm M tsar.'*w.wa!N dbaw Or MM PAN& O4M•wwM*M-%MMS. w%*,T%w&V U:wM AMMAI NOW 11w props"nu% tvc riMrmn N� w tf nm xtvpted a!au..wwlM�lMs •.+ra arta!rMlMlMw Mr stir wt vndba(14)da►% damap dww a arww ww" Oww•p" br M as tarts kgs 4 AM4nI The a0we prom. aid - -- cmdom tarrmtt hmn and arr AnrNy aaVptM You arc swuraw at/ror1 1 to ON 004 as 8M**d raymrnt'*40 tr MA&as oddmd ailorr svoatugv [aur d 4V 1 � i The Commonwealth ofMassachusetfs Department of Indristrial Accidents Office oflmestigations ki V, 600 Washington Street Boston,Masi 02111 www mass.govldia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information PIease Print Legibly Name(Busine�orymhatjon/ln,ividtw):Sexton Roofing & Siding Inc Address:P.O. Box 6327 Cit3l taternp:Holyoke, Ma. 01041 phone#.413-534-1234 Are you an employer?Check the appropriate box: Type etprolect(required): 1_C I am an employer with 4.;X I am a general contractor and I 6.1.1 New construction employees(full and/or part time)_* have hued the sub-contractors 7.Cl Remodeling 2-1- I am a sole proprietor or paler- listed on the attached sbeei ship and have no employees These sub-contractors have ❑Demolition working for me in any capacity_ employees and have workers' 9.G Building-addition [No workers'comp_insurance comp_insuraninsurance required] 511 We are a corporation and its 10.C Electrical n;pairs or additions 3.! I am a homeowner doing all work officers have exercised their I1.C'•Phanb' o repairs or additions myself [No workers'comp_ right of exemption perm MGL insurance Tequired]T c_152,§1(4),and we have no 12 XRoof repairs .employees.[no workers' 13_U.Other comp.insurance required] *Any applicant that checks bon:1 const also till out the section below showing their—ohm compensation policy i nibrmatien. i Homeowners who submit this affidavit indicating they are doing alt work and then hire outside contractors must sabmR a new affidavit such. *Contactors that check this box most attach an additional sheet showing the name of the sub-cootnctors and state whedw r er net these eetifies lave employees if the snb-contracters have emplwees,tbco nn.stpraride their workcen'tamp.policv number_ Icon an employer that is providag workers'compensation ince for my employees.Below is Ae policy and job srte —a ni�jormadon. Travelers Property Casualty Company of America Insurance Company Name: Policy it or Self-ins.Lic_9:UB-OG078982-19 Expiration Date:0610412020 Job Site Addressj til - 2 City/StatrJZip: /l�t f �T_.•-�� "44- Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration(date). Failure to secure coverage as required under Section 25a ofMGL 152 can lead to the imposition of crmtinal penalties of a fine up to V-,500:00- or one year impnsonmedt as-w-Ael as civil penalties in theform o a STOP-WORK ORDER and a fine of $250.00 a day against violator_Be advised that a copy of this statement maybe forwarded to the Office of Investigations ofthe DIA for coverage verification_ Ido herby certify der the pairs and penalties of perjury that the info " n provided above is true and correct Si Date: Print Name= =+✓�'E_7 _ ,��- "f��_�� r Phone#_ Y I c Official use only Do not write in this area to he completed by city or town official City or Town: Permit/license#" Issuing Authority(circle one): ].Board of Head: 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5_Plumbing Inspector 6.'Other Contact person" Phone#� CERTIFICATE OF LIABILITY INSURANCEDATE(WUWDDrfYYY) TNLS�tT1F1CATE IS ISSUED AS A MATTER OF NWORMATION 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 PROD AND THE CERTIFICATE HOLDER- IMPORTANT- OLDERIMPORTANT_If tate certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terrns and conditions of the policy,certain policies may require and endorsement_ A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME ORMSBYINS AGCY PHONE FAX PO BOX 713 (AIC,No,Ex* (AIC.No). E49LC1L WEST SPRINGFEE D,MA 01090 ADDRESS; 286TF INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A. TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA SEXTON ROOFING&SIDING INC INSURER L3= INSURER C-- INSURER _INSURER Do- PO BOX 6327 INSURER E: HOLYOKE,MA 01041 INSURER R COVERAGES CERTWICATE NUMBER: REVISION NUMBER THIS Is TO CERTIFY THAT THE POI lCiES OF INSURANCE LISTED BELOW HAVE BEEN 65-1®TO THE INSURED NAM®ABOVE FOR THE POLICY PERIOD IN>1CATED.NOTWITHSTANDING ANY REQUIREINENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WMI RESPECT TO W111CH TNIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HERM 15 SUBJECTTO ALL THE TERMS,EXCLUSIONS AND CONDffXM OF SUCH POLICIES.LORIS SHOUM MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR F40DL 3UBR POLICY EFF DATE POLICY EXP DATE LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (NMIO lYYYY) (M11=YYM UMTTS GOAL LIABILITY OCCURRENCE :$ COMMERCIAL GENERAL LABILITY )AMIAGE TO RENTED S CLAIMS MADE F-1 OCCUR- PREMISES(Ea rERAL rty one pets�m) i S &ADV INJURY ;# GENL AGGREGATE LIYTTAPPLIES PER GGREGATE i5 POLICY PROJECT LOC COMPIOPAGG °S AUTDYOB>LE LIAB111TYSINGLEANY AUTO aderd) i ALL OWNED AUTOS 30DILY INJURY ys SCHEDULE AUTOS Per pe—) ED AUTOS 30DILY INJURY NON-OWNED AUTOS ROPERTY DAMAGE ;S (Per 3mdent) 1 UMBRELLA LIAR M OCCUR EACH OCCURRENCE ;5 EXCESS L1A6 CLAIMS-MADE AGGREGATE S DEDUCTIBLE RETENTION $ �S A WORIGR'S COIIQPENSATION AND gWC STATUTORY 017HER EMPLOYER'S LIABILITY YIN U8-0GO78982-19 06104/2019 0610V2020 WITS ANY PROPERITORIPARTNEwExECU LVE RIA E L EACH ACCIDENT i S 1,000,000 OFFICERIMEMBE R E(CLUDED7 (M-Kia"i„" EL DISEASE-EA EMPLOYEE iS 1.000,000 if yes.desai°e uMer EL DISEASE-POLICY LAYT i$ 1,000,000 DESCRIPTION OF OPERATIONS belay DEscRwqioNc)FoPERATioNsILOCATK)mSrVEHICI &RES 1RIC 11006SISPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO TRE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE THE INSUREDS RRA WORKERS COMPENSATION POLICY.Ai'D ITS LUAHM OnIEA STATES ENDORSEMENT AUTHORIZES THE PAYMENT OF BIINUTIS FOR CLAIMS MADE BY THE DNSTJRMS MAEMPLOYEFS IN STATES OTBER THAN NUL NO At1TBOBTlATION IS GIVEN TO PAY CLAIMS FOR BENEFITS IN STATES OTHER THAN MA W THE INSURED HIRES,OR HAS HIRED EMPLOYEES OUTSIDE OF MA THIS POLICY DOES NOT PROVIDE COVERAGE FOR ANY STATE OTHER THAN MA- CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELI ID BEFORE THE EXFTZAT10N DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS_ AUTHOR12m REPRESI3RTt ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD 1988-2010 ACORD CORPORATION. All rights reserved. . .,'y-. ,r ybR ,f y.'Y J .i!•q� �1..'a,.fi a a ':'la? .... ... 6.l:� r �.. . >� .i'1 }rL.'�.:{ 1 '�',�*iai 'e��<µ�Ji l '!t • .:;'r i�`•9 1- I - t>•+...��.. •Tifl..' tS tt'J, F';:/!t ""M ' - .- .. i''�:i 'v[' 1.P / i. t. '��.%' .1 .hl'f� a C¢•^t �'!!�;.. _t,:.�. !'i .. ���� s Av • Y' � _ ,_, � '�s.. 1 Vii:� R'+•�� 1 r , 3 , .. � � .,. . .. ..... ...,'�...-iltt ZZs.'�+ �'v,E�..1 w r + .. J,P� �aII n .t.t' _. ..-�iW+• 11.7:•(.:R'4a r i... ,`,� •fir. ...... .. I r` . ... ......,. ..�_�...,. ..x,... _. .. ._.n � .^ "I'E - ' �,' ^ Y' } M r..... I' ,_ .-J ." ..... ,�. .~ ..._.. .,...�.-.sem._..�. •L_ '� ' � _ � ._.-. .... ..: _ .« .....r r.as. rY• .. Arra• r.J• ,. , S '#" Y.r t ��`• ;s: ". .+.«'pi • N.. 4. �1J4. i'`, t-.',r4! !�« - ... � - � >��+ - t �y .�u t .. ' � A, 4_ ,ti - - , . .r. .rw �.•.i{:: � wrrRG.Y »Y�tv. Mw'•a v..�,:. vnA+�[w•� ' .} �•r ,�..: r i.'T i ,^t 4 .,i. r� 11..3 a.: +w � _ Y Lm:Ya3 f �t .,F4 «� .. .. .....Y iw 1ti.S�'8�..x �- k,�` ., +• ��: .�..f+. L�,���3�7{..e'k''t��Y�i-sl j � ,� 4�.YYf�''r 144 „�. �-� SEXTO-2 OP ID:ER k.R CERTIFICATE OF LIABILITY INSURANCE np071'012""�019 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: tf the certificate holder is an ADDITIONAL INSURED,the porfcy(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 413-737-0300 CONTAC•r Eric Dembinske _ AME Ormsby Insurance Agency,Inc PHONE 413-737-0300 F^s 413-737-0617 698 Westfield St PO Box 718 AfC,No, !AIG No) West Springfield,MA 01090 A �1tls a Osbyins_Com Eric Dembinske - — IMSURERM AFADRDMG COVERAGE NAIC s INSUFMRA:Colo Insurance Co_ Sex _ NSURton Roofing&Siding,Inc.ID rf,,s�B:Quincy Mutual Fire Insurance 15067 — PO Box 6327 "4SURER C: Holyoke,MA 01041 ndsURER D: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER REVISION NUMBER- THIS UMBERTHIS 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 MSINRANCE sUaiz 'POI, p POLICY EFF POLICY EXPLTR O -- A X coummaALGENERAL LmaliIw EACH OCCURRENCE 5 1'000'0w CLAIMSUADE OCCUR y OIGLW2159M OW251201906r2W2040 OAMA&TORENTED� S 100,000 S Ea MED EXP one S 5,000 1,000,000 _ I PERSONAL&ADV 9 JURY S _ GaJL AGGREGATE L11.9T APPLIES PER f � GENERAL AGGREGATE S 2,000,000 POLICY❑JECT RDC i PRODUCTS-COL01PW AGG $ 2,000,000 OTHER I S B AUTOYOBILELN6LIiY I l ami CONBR�8RdGLELAHS T 1,000,000 ANY AUTO AFV206561 05115=9 10511512020 BODILY IUIIRY s OWNED SCHEDULED AUTOS ONLY X AUTOpSW�fg7 f BOOBY INJURY S PROPERTY DALIAGE X- AUTOS ONLY X ALTOS ONLY � _. -- i S UMBRELLA LIAH HOCCUR I H OCCURRENCE S _ EXCESS LIAR CLAIMS-MADE AGGREGATE DIED I RETENrTTONS S WORKERS COIWF]iSA77pN PERATLITE OTH- AND EMPLOYERS LIAINUfY YIN TO BE SENT SEPERATELY ANY PROPRIEfORIPARTNISVEXECISWE ❑ N!A• EL EACH ACCIDENT $ OFFICER/MEMBER DCCUJOEIP (Mandamry In NN) EL DISEASE-EA EMPLOYEES_ --.- If yes,desc be title I DESCRIPTION OF OPERATIONS below ! EL DISEASE-POLICY LANT S DESCRIPTION OF OPERATIOMS f LOCATIDM 1 VERCLES(ACORD 107,AddrWPwW Remarks Schedtde,may be a=ched if more space 6 nequhed) CERTIFICATE HOLDER CANCELLATION NONE-01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE IMWOF, NOTICE WILL 13E DELIVERED IN Everett Sexton ACCORDANCE WITH THE POLICY PROVISIONS_ AUTHORREUM RIPRESFNTATWE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION- All rights reserved. The ACORD name and logo are registered marks of ACORD . ,t:•'Fl.+"'e.1ji ts'?if3+' .,'t:+ si"".41 .(i ti,•c'ow.2Eh <. i �'li{.}�+�9 .. r { ' � 32P..�£';"�-':; ''t'• .> - � ..-+� J Y4{;�'+ i�t� �. 7: �i'afS.+ ;h4'•,LYir TM t _... ...,.. t ' ti.;�,vrttrlL, � tJ. s.rtr?'M� "'� »4'at�.-:, ley !'• dq.z.^) `.{+{ ! ''r,"ia jt.;.�,'4:.'�+'-`'��; }sSu"a"Y gv ''•t"''.4•w ut.c„ ..• !,.': ;.',t '! t ` r ' f ., .�•r.-. � ...:X4':+C.:... .'.Yj.. t _- .».:.�' .. .-�<7*•.,. '�4„'.f#CJs, , ,f;7�:z�ti.iw A .+•r,.tl. ?+�9.. 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N i .'G..��L ''I.-�'M,. $ f `7R ) i��'• �"P oJSJIs S�.sr�tr.4'.3 (( i, The Come wffw►ealtk of Massackusetts Department of Industrial Accidents I Congress Stree4 Suite 100 Boston,MA 02114-2017 wwwcntasxgov/dun V owkers7 Compensation Inseraum All[Whavitt:guilders/Contractors/EleciricianslPlumber-- TO BE Fi XD FITS THE TEMM'ILNG AUMORIT5: Ag1plirjnt information please Prim I&Zibh Name(BusinessYhpnizationindividual): AIA/9 t ityitater'Lip:_�1,1,� � j Phone#: Are your za employer?C:beck the appropriate boz l Type Of prom( I )' ! Ell am a employer—th_-- ._.employees(fall and/orpart-time)-' 7. ❑New construction 2Q1 3m a sats propneror or parmerslupand have no em R pbyres worlcieg forms in S. Remodeling I am crp-..crt)'.lNo markers'comp hnshhtarte required-] t—t f 3 Ell om a hameowne"Orng ail uvrk m�sdf lNo wm iem'comp.nh xwxe requn,d,j' � 1 9. ❑Demolition Ii 4 nm I aa homeowner and twit/be hiring contracxors to cothdhx.tall work on my property. !.will 10[]Building addition. crism that all contrretors either have uvrkers'compeaaathoo inawance or are sole I LEI Electrical repairs or additions Proprietors with no c nployves 12-[]Plumbing repasts or additions 5 Q tam a genesai contrwtor-md I have hired the sub-contractors listed on the attached shut ' 13. Roof its Ihese sub crrhtractors)hatir employees and have hswiers'comp inserrance.= ❑ e-.Q We are a corpor.Mon and its officers have eh:erciscd their right of exemption per MGL c t 14.❑Other 1 S'.§1(4).and uc have no emptoyres [No wwkers'amp.insu mm requital] `Airy applicant that checks box;1 t what also fit out the section behove showing their uvrken aornpwsabon pohgy mfen=m. y f forneowners vow submit this albdayit indieatmgttey we domS all uv&and then hire outside contractors mast v msit a new afftthvit uKkating such =Cim�=om that cheek this box must attadmd an addiuorril sbee shmving the narne of the 5rtb cotrtraetnrsattd state whetheror trot those entities hale cmployces If the suh-cosrtracta.herrt employees,they must provide thcir uvrl-crs'comp pokey-number. t am an entpfoyrr that is providrn.,warken'compensadon frnsurance for nW eiWIoyem Below is the policy and job site informado,L Insurance Company Name: Policy or Self--lac.Lic_ Expiration Date: i (e v Job Site Address:— CitylState/7.tp: Attach a copy of the workers'compensation porky declaration page(showing the policy number and expiration trate). Failure to secure coverage as required under MGL c.152,§25A is a criminal violation punishable by a fine tip to S 1,500.00 and/or one-year imprisonmenL as well as civil penalties in the fort of a STOP WORK ORDFR and a tine of up to P-50.00 a da}'against the violator.A copy ofthis statement may the forwarded to the Office of Investigadons of the DIA for insurance coverage verification_ I do herrfry certify under the pains acrdd pexaaf/ties ofpalurJ'that the iaforemrion pro=W above is byre and correct Offrciat nae only_ Do neat write in ddT aruaa,to be eo=*eW by city ar toren offuial City or Town- PerwitR,cense# Issuing Authority(circle one): I.Board of Health 2-Building Department 3.Cityffown Clerk 4.Electrical Inspector 5-Plumbing Inspector '6.Other Contact Person- Phone#: d. fj'. z rs� x...41 Si. ,.. s - ,.. • t � t. - ,. yy .i � � � i } �� i' t � 4 tit �;� �- .t � i� t `. -k`s � s - f•�• _ •+ t-,. j :j :�-� � � 1: r 3 ' � >s g ,, `�. 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A�Rte® CERTIFICATE OF LI ABILITY INSURANCE °A�M�° THIS CERTIFICATE IS ISSNOT AF AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER-2019 CERTIFICATE DOES NOT AFFiRMATIVELy OR NEGATIVELY AMEND, BELOW_ THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT EXTEND R ALTER THE COVERAGE AFFORDED 6Y THE POLICIES REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER BETWEEN 17iE ISSUING INSURER(S), AUTHORIZED IMPORTANT: If the certificate holder is an the terms and conditions of theADDf110NAL INSURm,the Policy(ies)must be endorsed If SUBROGATION IS WAIVED,subject to certifiicate holder in lieu of such etrdip ,certain;olicies may require an endorsement A statement on this certifica6e does not confer rights to the PRODUCER ntls)" ONE FAMILY INSURANCE AGENCY LLC Calvdlo (978)403-1 FAX 1 Main St Suite 15 A acaWO12 caul "� ---- Lunenburg 111SUs7 wsuRm _ MA 01462 iNSUREtA: HARTFORD UNDERWRITER SIS N pa MNP CONSTRUCTION INC 30104 INSURER a INSURER C 45 EXCHANGE ST APT 3E INSURER D: MILF - MILFORD INSURER E- COVERAGES MA 01757 INSURERF- CERTIFICATE NUMBER 478475 THIS IS TO CERTIFY THAT DIN POLICIES OF INSURANCE Vy^7Ep gaDyY tiAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERtOp INDICATED_ NOTWITHSTANDING ANY ES OF INSURANCE REVISION NUMBER CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITy EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWNC11AgYFiAAFFOVE BEEN REDUCED BY PAID CLAIMS. RESPECT TO WHICH THIS INSR POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, LTR T�OFIKSUBANCE 5 COMMERCIAL GENERAL W1BIUITY POLICY NUMBER POLICY EFF POI.)CY EXP --- i UI4Ri5 CLrVMS6RADE OCCUR ! i EACH OCCURRENCE S - DAMA j1 I PRE]Nt$E$ J N/A 1 MED EXP(Ary ane Person) j -- GENIAGGREGATFLWTApPUES)�: 11( j PERSONAL&ADVIKIURY j POLICY C)� n OTHER: Loc ; `' i GENERAL AGGREGATE $ — � PROOUCTS_COMPiOPAGG S ---- AUTOMOBILEIJABRny .- i ANY AUTO I COMB.UIED SBJGLE UINI'T j ALL D SCHEDULED AUTOS AUTOS NIA BODILY INJURY(Per person) S fiIRED AUTOS AUTOS A J�N-0V4IJEll � BODILY INJURY(Per accmcpl PROPEiRty aM1AGE---— - UNBRELLAUAB s OCCUR � � j - EXCESS LIAR '' —r-, CLARA ADE_ WA i EACH OCCURRENCE S DED 1 A COW4BNsATON $ I f AGGREGATE — --—-- $ -' ------ -- i YES'UABILITy s YIN I PER A o�c� / ❑ I i x I sr (Mandatory In III NIA NIA Nm 6S60UBlK70970619 EL PIKE ACCENT It yes,de�eunder i 11/16/201911/16/2020 s 1,000,000 DESCRIPTION OF OPERATIONS bemv ! EL DISEASE-EA EmPLi 1,000,000 ti ELOISEASE-pOUCyUWr S 1,000,000 1 IWA J DESCRIPTION OF OPERATION$/LOCATIQNSIygpC _.-----'-�--- --- ' -- Workers'Compensation benefits v4 d be IACORD �Add,>i� �s��°`al'ere aftaded amore�e 6 claims for benefits to employees in Pard other Massachusetts employees Pursuarrt to Endorse " I states other tfian Massachusetts if the insured hires,or has hired merit WC 20 03 06 B,no authorization is given to pay This Certificate of" those employees outside of Massachusetts_ IrisuranCe shows the policy in force on the date that this certificate was issued(unless the expiration date on the above issue date of this certificate v insurance)_ The status of this coverage can be monitored daily by accessing the Proof of Coverage_ Search tool at www_mass.gov/twd/workers Com Policy Precedes the Pensationln ations/. efag Coverage Verification CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE SEXTON ROOFING &SIDING INC THE EX�TION DATE THEREOF, NOTICE Ma BE DELIVERED IN 102 PINE ST ACCORDANCE VWTH THE POLICY PROVISIONS_ AUTHORit1D�RESEVTATIVE HOLYOKE MA 01041 ``'`, �nie!M• .CPCU,Vice President—Residual Market—WCRIBMA ACORD 25(2014/01) The ACORD ©1988 2014 ACORD CORPORATION. All rights reserved. name and logo are registered marks DIP ACORD �v, •9.,et::f t$/.t .:�. i .. 'iAl.{+ .4�:L,rS,�t..- �'r tt,,*�t�t : •tt t r :.� i{; . '�'�.►:,i .. r Tr �.r+ --!�r y M u+.ate {d N:.,e a `�'"� "rr"^ ,!+� C,�' tom•,-.,•Y `J }rt l `,.t, .' 'F. w . VIA, .�,,. �. ..2CQft9'. M•#•tr;v at ,:.> !.. (:,9119: Afa - .•`t R a ! Kl-,:'. • xn "r• +: -R:i. S+k!.5,�rS4t, t.• " L a Ed tJF 's. 9�+uG. T t} N c Y' tor- 1•'C ti}rJ 1' tt .g u►,t�. 4 +ver J 4nl� h cat� ,< fl* eK j7 6luN -•a 'i t37' <`' j}L r� tfrt*7+".J Af f 1 :u,¢ , .ter, As97r*aw�,t n e w ,$,a.,!!!� a ;• h •zr, .:t . 'sct 1 t. 'IrF Gt ,. a Cki S Ai!►:t .. �. .°'Cu"..;+.fra.., s99,6v):y`}'A�'fC� 7 1 it:'S°5`��'��' ' +' � �♦ :arrR ..- -._:x,S.M,n r ..:_... .. ..... . .. -•-a ..+s�'rt ..rF Y�'�'•6 Y.�r Mt•'.'f• .•� i..e P', C'1: � f+ .a r4 5--...".OSofS►'' v:`ir l..�S.y"a9t•).�!_ ..,, .. .. �' i Y } f e,. " r.' tPrt'2 ,�1,4N'i' r} '.awl '•� \ 1 A. C n Rlt-tar , f �� , t'I t f Cw �4..VCM,J' !. .�. •.�..�..1 , ,�y u. 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(•�- •.,r�tY �`t�� .t sy yw �/p� �y '_Y1(;;:•td a • S I.S J Y P"4 JS2. ,�a�,� S _ �4 T.�.L I�+P: ��� `f9Jffl1."d4.=;rf•G�3�F-'•• ��� rr �.-44',s .,.v.Y 1, '' '.t 4 ';is i/> .. a ' Sc i., dv+ i j,s.'1,a / .i°�r.�,?' 11iPr•• �. '.} f 'i• �i Stu^+:y s'�•!+> � 'T.'�r'. «; k#RtY p1•t1�"7f{$+ .it3A^':a �� r�* y#1 i. c{ vt"1 L}ii + ;3!? iY'? r 1Fi :'«r31.; 'r 3iri[, {'i A.��'�^t '•L '�,6-::+3 N*M ' � l.L....':. .. .'..,1,. 5>^! 'k ^fit? _ ,��•fi.t ,l ._.Y ,t.'.. �,�, r+rTSw Cwt'�51n !ii t°r!'4 'r• o.,.... .L... ..,.t I.' A Q CERTIFICATE OF LIABILITY INSURANCE D" `�, ' 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 terns and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rigtrts to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Art Calvilto One Family Insurance PHONE 978-403-5942 tAjcFAX Nn. 978-403.5943 1 Main SuiF Lunenbururg,MA 01462 15 ADDRESS: ad@lfamilyinsurancecom INSURER(S)AFFORDING COVHtAGE NAIC l INSURERA: Evanston Insurance Company INSURED OISURERB: MNP CONSTRUCTION,INC. INSURER C: 45 EXCHANGE ST APT 3E MILFORD,MA 01757 INSURER° OSE: INSURER F: COVERAGES CERTIFICATE NUMBER REVISION NUMBER- THIS UMBERTHIS IS TO CERTIFY THATTHE 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 ALLTHE TERMS, EXCLUSIONS AND COWXTIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR EW LTR TYPE OF INSURANCE MwWvD POLICY NUMBER POLICY EFF POLICY 1-41rr5 X COMMERCIAL GENERAL UABILny EACH OCCURRENCE $ 1,000,000 CLIkMS-WDE �OCCUR PREMISES Ma ammenweS 100,000 MED EXP VUV one ) S 5,000 A Y Y 3ET9385 11103/19 11103120 PERSONAL&ADvmAIRY s 1,000,000 GEWL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 POUCY E]�T LOC PRODUCTS-COMPIOPAGG S 2,000,000 OTHER S AUTOMOBILE UABUM COMBINED SINLnwr S ANY AUTO BOOILY lN.A1FZY(Pvpelsan) S AUTOSAUTOSSCHEDLID BODILY N.II.KY(Perai®dmt) S AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE S AUTOS ONLY AUTOS ONLY $ UMBRELLA LIARHCLAIMS-MADE OCCUR EACH OCCURRENCE S EXCESS LIAR - AGGREGATE $ DED 2 1 S WORKERS COMPENSATION STATUTE EgTH- R AND EMPLOYERS81 'LJALRY Y I N ANY PROPRIErORIPA9TNERID(ECUTIVE❑ N/A El EACH ACCIDENT 5 OFFICERlMEIhBER EXCLUDED? (MamutDry in NH) EL DISEASE-E1 EMPLOYEE S If Yes.describe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ DESCRIPTION OF OPHRATIONS!LOCAMONS!VEHICLES(ACORD 101,Additional Remarks Sche(hYq map be alfaebeel a more space Is mqu ed) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCE)IF BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN SEXTON ROOFING t£SIDING INC ACCORDANCE VA TH THE POLICY PROVISIONS. 102 PINE ST P.O.BOX 6327 AUTHORIZED REPRESENTATME HOLYOKE,MA 01040 ART CALVIt I O ®1988-2015 ACORD CORPORATION. AN rights reserved- ACORD eservedACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Ti, :�.{1 A. .i •roih':�. }f Y';.f."#.<7 Wei•`."71'0.1 f'4!:i; A Iq OW4. 01 9 !3`Yti 4^"t:Wl. { ' P ' r ";w'�K.A, ,� ...H1.-b�_ �"r... 'Y".:r,...1T':Awp� :erae+a. ,,,,M.. .. .�,•;r.�1y,,� :p,..,e•!- !. .a{. .. ,. } ,I Y i^ ax �. ! 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S#ai.-%VK V.T! iF _..�.liae{lvAt 4 l fk- %sf" V-Z4 {'; trk l-Tof s;r iw,:t tr J,g sa} t-fib E r: .70 , iy i l; �i y Di"�`rtf 1r R t � r r R i ir'1+ «4iw r t`1i 'Ew� LiK Offile�CO a'Y ; oshoilAla � � 02,18 :10 S3X-ROOFWG$SIDINGtAjC LYON MA 010--iw QWjAt ; -- P0 BOX 6-V-7 am o � ao � per. R SgMWIA �CTp sEXT HIC.0605383 SIGNED 11/30/2020 E- _ _ Commonwealth of Massachuseiis Division of Professional licensure - - Board of Budding Regulations and Standards Canstructios,4r Specialty CSSL-099689 � � Pi =10/05!2021 1=1I�RElTJS�Xr -' � r _ PO BOX 6327- J .n: Commissioner /t f� , :tilt"'!�:•*R,.aS7a`.:. ,�.. .,.. ` .:,'l�� �. + '�', _. _... ... moi:'�-. `� r � -;i;,J c_ ,t!'•. .... .e,.'. .. _ ... g�Ate.•- y�� � ''�`� ,al,�iLf...�' .�.�L'I,t. s�. r - ., . - .. .. ' _� �:�"a'�5!?,.L'�4�ltt$�+;t:K .t> xb- � ��.. I � .._.» _ .. .w•'i_?s ,c✓)trltl�+�+?4+ x 1 L'R : "�_ s±'Q.��,^�edN'`Y'•'e..�"cs`..:, ��.,. /xK�4 J f{ wr/9.y L✓ �'i• k Oji+ _ . '�:: .•S� i 't4.�"'�:t7�fr ` W _�'Vfiwn'.'r5+4� '-�''°o- "r, �� ��- - ._ , � � 1.'+! .. � �.. ir k �i . � � .,,,� �{,��*��s:..r'!'�,,, •.tet' - �.'�.�' �, ,. •• j� r; .. - From: f ..................... 447) � ( ,eg 7b: Louis Hasbrouck Building Commissioner City of Northampton 212 Main Street Northampton, MA 01060 The Massachusetts Building Code,section 107.1 allows for an exclusion from;requirements for construction control in certain situations. In accordance with code section 3.04.10,I request that you grant a modification to waive the requirement for construction control of the project at 1:2 ( 1Jr l�, AC Because the work is of a minor nature,Will not affect structu safety,and will be lane in accordance ral elements,health,accessibility, life or fire with the prescreptive requirements of the code. Thank you for your consideration. Respectfully, . -- � i � I, . . .� r - ,, . � � ��� ;� _ , . . .. � � . . . : -, � . ,:. - � '� .. • — � r ��: i � ... .. ,. r �.: '.;,. e ,,. . . � - � ,� . � _ _ � _ _ � � . j'i _. � _ .i. / ... - .: � �, � _ i - - ..-. ' .` � - Y! ' .. _ � I . � � .- .t � _, r.. � � �. i � � � t - - .. �