Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
41-045 (2)
1352 WESTHAMPTON RD BP-2021-1268 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:41 -045 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: shed BUILDING PERMIT Permit# BP-2021-1268 Project# JS-2021-002105 Est.Cost: $12800.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: SEXTON ROOFING CO 99689 Lot Size(sq.ft.): 40685.04 Owner: LINDSTROM ASTRID J Zoning: Applicant: SEXTON ROOFING CO AT: 1352 WESTHAMPTON RD Applicant Address: Phone: Insurance: P O BOX 6327 (413) 534-1234 WC HOLYOKEMA01041 ISSUED ON:5/3/2021 0:00:00 TO PERFORM THE FOLLOWING WORK:STRIP & SHINGLE SHED 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. A Certificate of Occupancy Signature: 4- ' r .>2 55201T FeeType: Date Paid: Amount: Building 5/3/20210:00:00 $40.00 212 Main Street, Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner • sZ, The Commonwealth of Massachusetts ' Board of Building Regulations and Standards i' Massachusetts State Building Code,780 CMR,7a edition rCJ Building Permit Application To Construct,Repair,Renovate Or Demolish a Revisedlanualy One-or Two-Family Dwelling 1,20JJg This Sect' n For Official Use Only / a 2 9 20 I i 1 Building Permit Nu bet-. p"2 i.. j� 0 Date Applied: , • ,,,flog-o�rttl Signature: • • • 9- �tl" �11Z '`_ 'tli,Tntv!NS CrloNs Building Commissioner/Inspector of Buildings Date oso - ' SECTION 1:SITE INFORMATION - 1.1 PropertyAddress: 1.2 Assessors Map&Parcel Numbers l 2) a t.t.�-9 Wr I-/ - Lfl' • 045" . ' 1.1a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use __ Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) FrontYard - Side Yards Rear•Yard Required Provided Required Provided Required • Provided . 1.6 W'ater Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public❑ Private❑ Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0 Check;if yes❑ • SECTION 2: PROPERTY OWNERSHIP' 2.1 Own r'of Record: ,ram' s Kt 0 L k nit'J5►,L.0,44 - , 3 5 -W-4)��,,A...te4-v.,/ • Name rint) - Address for Service: Qom-t4 Alkz- V . 55-- FPS y - Si azure Telephone • SECTION 3: DESCRIPTION OF PROPOSED'fi'ORK2(check all that apply) New Construction❑ Existing Building G''-Owner-Occupied tThepairs(s) U Alteration(s) Q Addition 0 Demolition 0 Accessory Bldg.0 Number of Units / Other ❑ Specify: Brief Descripti of Proposed Work2: 1ei v. G)& x icy i -7 /c-e-,-' • SECTION 4:ESTIMATED CONSTRUCTION COSTS. • • Estimated Costs: Item - Official Use Only (Labor and Materials) I.Building $ 1. Building Permit Fee:$ Indicate how fee is determined: - 0 Standard City/Town Application Fee 2.Electrical $ - ❑Total Project Costa(Item 6)x multiplier - x 3.Plumbing • . $ . • 2. Other Fees: $ - 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Total All4W Suppression) ' Check No L w etk Amount: Cash Amount: 6. Total Project Cost: $ C-2 1 ` ?(1 ❑Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) {Or. S1 tI"erei"f.je 101) LicenseNumber Da e ' Name of CSL Holder // j OK (0�7 List CSL Type(see below) AL= i NJo and Street J f� Type Description !U/�.f�if c_ 1f' UI(//� R Unrestricted(Buildings up to 35,000 cu_ft.) R Restricted 1&2 Family Dwelling City/Teozo8,State,ZIP M Masomy RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances I Insulation -- Telephone Email address D Demolition . 4111 5Z Registered Home Improvement Contractor-(HIC) C \3 3 ax n o n 05/r,r/��f and W,,� i 1�a 3 - r -l-!?�� HIC Registration Number - £xpiration Da`tc HIC Co any Name or egistrant Name .J Ea No.and Street F ill address City n,State,ZIP Telephone SECTION.6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT( .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 ' 'Ede' No ❑ SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1,as Owner of the subject property,hereby authorize 3fV e Ii �,�` /•l(I' df/7q to act on my behalf;in all matters relative to work authorized by this btuldirtg.?ermit application.LJ t�c��lfrr��f o/ riehed Print Owner's Name(Electronic Signanse) to SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION By entering ray name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this plication is true and accurate to the best of my knowledge and understanding_ /Z-2/Z/ MUST BE SIGNED by Owner or Authorized Agent Date NOTES: I_ An Owner who obtains a building permit to do hisfher own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will pi have access to the arbitration program or guaranty fund under M.G.L.c.I42P Other important information on the HIC Program can be found at www.mass.govinc Information on the Construction Supervisor License can be found at.1,�t,y_masc g,ovtdps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed _Open 3_ "Total Project Square Footage"may be substituted for"Total Project Cost" City of Northampton , Tun✓p O ... Massachusetts �2S,s. .::' sc�i ‘i! E ,,cI DEPARTMENT OF BUILDING INSPECTIONS t -+ 212 Main Street • Municipal Building J �� a'' tr4:f Northampton, MA 01060 CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) in accordance of the provisions of MGL c 40, 554, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: Location of Facility: 766 di/1/r S% /iv /Yo _ 0i'2 q- The debris will be transported by: Name of Hauler: jA SCoc 14-'4 y <r/ 1 ‘-'7CT Signature of Applicant: Date: ,/.Z�/-z/ Proposal SEXTON ROOFING AND SIDING INC www.sextonroofing.com IKO P.O. Box 6327 img- Holyoke, MA 01041 Setting the Standard '. rr a` I. .asolt MINIM 1■06- p. 413.534.1234 f. 413.539.9906 MAHIC # 118239 sextonroofing@hotmail.com SUBMITTED TO Astrid Lindstrom PHONE 552-8524 DATE 4/13/21 STREET 1352 Westhampton Rd lindstroma216@gmail.com CITY,STATE,ZIP Northampton, Ma. roofr SEXTON ROOFING HEREBY SUBMITS SPECIFICATIONS AND ESTIMATES FOR: 1) Strip and remove existing shingles and dispose of in proper landfill. 2) inspect roofing deck and replace as needed @ $95.00 per sheet. 3) Install new metal edging to rakes and eaves of roof. (brown) 4) Install ice and water shield on eaves ( 6'), vent stacks, in valleys, chimney, and at intersecting roofs. 5) Install #15 synthetic roofing felt on remainder of roof. 6) Install new flanges over existing vent stacks. 7) Install starter shingles on eaves and rakes of roof. 8) Install IKO Architectural style roofing shingles as per manufacturers' specifications. 9) Install new cap over ridge vent. 1a eest-ef-sk .4\ ct r t do 0-4ss Now dlSo�ler 11)install new lead flashing on chimney. �Z CUrrQ.tlt p D rr \.A 5.V-1 115 12)Supply manufactures Lifetime warranty and SRC 5 yr. workmanship warranty. lbC'_C-ts ion ckzuk uit-1 wit MOCIC.. \ i coop j�`�J t ' cfle,i-l4 d15CUSSioll We Propose he»by to fur alaa.abx at and&boa cool .to b accordeea with dm more speelleatione,for the aorora t oft °-�-4_ PAYS BE AS FOLOM$r Twelve— inotrsawo�r�vw aru�.r.+...a �1,80b.00) due In MI upon completion All Material is guaranteed to be as specified. All work to be completed in a Authorized workmanlike manner according to standard practices. Any alteration or Signature deviation from above specifications involving extra costs will be executed only upon written orders,and will become an extra charge over and above the estimate.DAMAGES TO BUSHES AND OTHER VEGETATION'MARKS ON HOUSE MAY BE UNAVOIDABLE AND WE ARE HELD HARMLESS. Not responsible for water Note:This proposal may be withdrawn by us if not accepted damage during construction. Owner to pay responsible legal fees for non- within (14)days. _payment,and applicable interest. Acceptance of Proposal The above prices, specifications and conditions are satisfactory and are Signature hereby accepted. You are authorized to the work as *1-1-A, specified. Payment will be made as outlined above. Date of Acceptance. Signature . . . • •• , . • ....... _... . .. ._ .. . . . ._...... , .. . • . •''.4.4%. tl-a i .1.- Ai., ,, 010.44 .. • 0 Ia.,. sge..Ili ,,...lik -, ,p T id C VIA rtak,-- /VI I 1001 4. ? ti ,iik' C - •-1(.;.':s," '''' ;"1...11:;$C.., ''.4'..:'''t' '41/VVV . . • ' . , • . .... .. : • . ii'';',:ii''...•..:t.'...,-,:e.,...;',, i,se,:Ak `'!, • `..`t•,•'-.• ' ' ^::,-',.,-.4• ' •'....-,IPC.?..*.e -t.',,tt . ... • • ..-- . • , • • .. ' '• ''...t:.-1 '''‘ . • ri••..r,•-•„' . . ..1 • ••••""i'T '. ..'f: .. ...r. . ,. ... . . . , .. ' - ...!,1 :,/ '', ri'.;, .:;•:.q-e-4 . • .:1•.-, 1.-3, - - • . . . ... . . .... . .„. . ,.• ` ° ' - - • . -'`ril ,.: • 71 ' .... _ , ..... ._ . • .._. _ _ . ' . •;- ' ‘i' ' - l'•.., ' '''' ...-11.')F;-';•., '.. ,.. I . . ''.;1.r1,.;'• -,•:_,„-„'.. .'" i . ..-!e: ,•• -,..,.: ......•,0* ; • 15, ;:.'.. ' ..' , .-*;. . . . ;i' ..f.;.':': ... , . .' ., .. ',. - _,..).•'. , • ..• ..--, t . .•.r.-si.:;',./,- rtc.:,,,cil ;or. , , 4 i•• .1,.t.,:, i„.;:.;; ,.. . • r . :• , ." ' :, . i • , • - '- - r. -111: '' '''f' *I ' ":1!'''S. ' ' ' ...- f).° , %. ,r•I ' ...,. ,.....' :cs. ...t.,., . ,...._, . '. , ,.-• , --' : • : ' t-• ' • •• . • , • 7.• '- %"; -,:2.4 ''..i.ii-....::. ••.7 • t,:- -..,-. '--;:!. P...;,;4,: e,:-., , • ,:.,•1 ‘4 '.•:- --, • /.i'T:•:V''. . 't , •3•114'..)4*S...,-;•:,'.• Lli. '. 'i.... -..,......',',1)-'''.:4*-: 'ir.-..s.1 r'.. •:•• '-f,'t..,' i , •t ,:.'Ji . ,,' •-.• i- .,',•'.,;-... „: ' '• *. '.. • 71;", •'" ° (4 ' '' te .-, . • . • ,. ' ,...., .si, if-. ....'. '. ''''..-t.-.'" ' ' • . .. '' •:".,)v-i'. •-'•'..aV-ik --• •.4., . - ,,.., fit- .-...,. ..1...,,v/ 1 „, ... );,- „, ...,,,,-z; -,. ., ,..!;., 4J - , . . . ' ; •-... .,; fi -.!,i.4••• ':, .. , . . , • . . • . .''i . . . : • . • . . • . - - ._ . •s_ - •`'-,,iV,,: ''..-k •. t• -,C'.'7..1:-‘ - r'_.'. *.k..0, 1, ,:e•:•-:. -., ,$,:-.+PI,.4A,• A...,..'-'' , ,-'..:,..i,"1.;.t. --IA.. '....Y; ',' ."'. •. :.•' . ..,,' - "?. ' ,-,.7. ..:"•• " '..`..';:!..4-:-4),4. •-- T.'-.,. . .-....' .2-•.:4_ :`," . .,..--;;;'''.1' ''', .:-';--r; • - :: '' - , - . . , NT i--.v...gat.v.i.. . ...-... , Pt „.. -,,,, . . • . . ... ...... . . ._. , . . . a - .." , ...... . . ' . .. e , ;f:, , -.''' .:.; ',. -.)r.,1,‘.!,i • - ,,,•,-. •--‘•,. - --'ii., . -- •• . • .. .- . .,., - ,. ,v.,.... A; . •+ ' . , ... . -. . _ .-. • . , • - . - - . . . ... -. - " •-4 ' .. ,-,. ‘..• , '.' ' - ........ .....-.........------ .... .. . . ---. .... ...... _— .. '.. ,........-- . ___ . • , . . . . . • 11 . • Department oflndustrialAccidents . , �.,-, Office cce of Investigations A I Lafayette City Center l 2Avenue de Lafayette, Boston,MA 02111-1 75 0 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual):Sexton Roofing & Siding, Inc Address:P.O. Box 6327 City/State/Zip:Holyoke, MA 01041 , ', Phone#:413-534-1234 Are you an employer? Check the appropriate box: • Type of project(required): 1.❑ I am a employer with 4. © I am a general contractor and I 6. El New construction employees (full and/or part-time).* have hired the sub-contractors listed on the attached sheet. 7. ❑Remodeling . 2.❑ I am a sole proprietor or partner- ship and have no employees These sub-contractors have 8. 0 Demolition workingfor me in anycapacity. employees and have workers' p ty 9. El Building addition [No workers' comp.insurance comp. insurance.$ required.] 5. 0 We are a corporation and its ' 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. .right of exemption per MGL 12.©Roof repairs insurance required.] t c. 152, §1(4),and we have no . employees. [No workers' 13.❑ Other 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 anew 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. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:Travelers Property CAS CO OF AM ' Policy#or Self-ins.Lic.#:7P4UB0G07898220 Expiration Date:6/4/21 jv Job Site Address: 3S� We g��/ i") /zi City/State/Zip: /lke-A9 i 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 of MGL c. 152 can lead to the imposition of criminal penalties of 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. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for i . Trance coverage verification. I do hereby certify under t ins and penalties of perjury that the information provided ab a is true and correct Signature: Date: 2 7 /2/ • Phone#: 413-534-1234 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(check one): 10Board of Health 20 Building Department 30City/Town Clerk 4.0 Electrical Inspector 5lumbing Inspector 6.0Other Contact Person: . Phone#: Aco 'CERTIFICATE OF LIABILITY INSURANCE DATE( MIDOIYYT`) A �/ 06/09l2020 THIS CERTIFICATE IS ISSUED AS A MA i I ttt 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 WANED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME Kathi Hutchinson ORMSBY INSURANCE AGENCY Lektc"PHONE (413)737-0300 (NC (ArG No): Ate, : khutthinson@onnsbyins.cnm P 0 BOX 718 - INSURER(S)AFFORDING COVERAGE N JC# _ WEST SPRINGFIELD MA 01090 INSURER : TRAVELERS PROPERTY CAS CO OF AM 25674 INSURED INSURER B: SEXTON ROOFING&SIDING INC INSURER C: INSURER D: - PO BOX 6327 • INSURER E: HOLYOKE MA 01041 INSURER F: COVERAGES CERTIFICATE NUMBER: 541733 REVISION NUMBER: . THIS IS TO CERTIFY THAT THE POUCIES 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 POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.' INSR ADDL SUBR LTR TYPE OF INSURANCE .M MD D POLICY NUMBER MIDO1 EFF. POLICYEXP LIMITS -(MFlIDDIYYYY) (MWDI OYYY1rl COMMERCIAL GENERALUABILI1Y EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES(Ea accu ren®) $ MED•EXP(Any one Penal) S _ N/A PERSONAL 8ADVINJURY $ _ • GEN'LAGGREGATE UMITAPPUES PER: . " - GENERAL AGGREGATE $ POLICY JEo- ,LOC • PRODUCTS-COMPIOPAGG $ + OTHER $ AUTOMOBILE LIABILITY COMBINED SWGLELIMIT S (Ea accident) ANY AUTO BODILY INJURY(Per person) S • ALL OWNED SCHEDULED • • AUTOS AUTOS ¢i N/A - - BODILY INJURY(Per adent) $ HIRED AUTOS NON-OWNED. ' PROPERTY DAMAGE $ _ _AUTOS (PerSmdent) S r _ UMBRELLA UAB OCCUR EACH OCCURRENCE $ • EXCESS LIAB CLPJMSMADE N/A • AGGREGATE $ • CEO RETENTIONS � $ WORKERS COMPENSATION ' l X STATUTE ( rER • AND EMPLOYERS'LIABILITY YIN • ' ANYPROPRIETOR/PARTNEREXECUTIVE - EL EACH ACCIDENT $ 1,000,000 A OFRCER/MEMBEREXCUJDED1 NIA N/A WA 7PJUB0007898220 06/04/2020 06/04/2021 - (Mandatory in NH) _ EL DISEASE-EA EMPLOYEE$ 1,000,000 If yes,describe raider DESCRIPTION OFOPERATIONSbelow _ ELDISEASE-POLICY LIMIT $ 1,000,000 WA • DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES(ACORD 101,Additional RerearlaSchedule,may be attached Wrhore space Is required) Workers'Compensation benefits will be paid to Massachusetts employees only_Pursuant to Endorsement WC 20 03 06 B,no authorization is given_to pay claims for benefits to employees in states other.than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www_mass.gov/Iwd/workers-compensationfiinvestigations/. • 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 f 1 Amherst MA 01002 �-f". C - Daniel M.Cr ey,CPCU,Vice President-Residual Market-WCRIBMA ©1988-2014 ACORD CORPORATION. All rights Iesurved. ACORD 25(2014/01) The ACORD name and logo are registered marks bf ACORD ACO DATE(MWDD/YYYY) C CERTIFICATE OF LIABILITY INSURANCE 6262020 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 ALILX THE COVERAGE AFFORDED BY THE POIJCIES BELOW. THIS CLRIIFICATE 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 endorsemerrt(s). PRODULER CONTACT NAME: Oiuo by Insurance Agency,Inc. PHONE (413)737-0300 FAX (413)737-0617 (A/C,No,Ect�: 1 ): 698 Westfield Street E-MAIL ADDRESS: West Springfield,MA 01089 INSURER(S)AFFORDING COVERAGE NAIC INSURER : Colony Insurance Company 39993 INSURED INSURER B: Sexton Roofing and Siding Inc INSURER C: 102 Pine Street INSURER D: Holyoke,MA 01040 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER_ THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE ll51EL 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 ADOL SUER POLICY EFF POLICY ESP R INSD WVO POLICY NUMBER (MM/DDIYT TTI (MM/DDIYYYY) LIMITS A X COMMERCIAL GENERAL IIAAILTTY 101PK0002159905 6/25/2020 625/2021 1,000,000 EACH OCCURRENCE $ CLAIMS-MADE X OCCUR PRMI E ID PREEMISES 100,000 S((Ea Ea omma�) $ MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY I s 30,000 GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE I$2,000,000 X POLICY JET LOC PRODUCTS-COMP/OP AGG S 2,000,000 OTHER S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accdent) ANY AUTO BODILY INJURY(Per person) 5 ALL OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS AUTOS NON-OWNED PROPERlY DAMAGE HIRED AUTOS AUTOS _ (Per accident) $ UMBRFI I A LIAR OCCUR EACH OCCURRENCE S • ESCESS L1AB CLAIMS-MADE AGGREGATE S DED I RETENTIONS WORKERS COMPENSATION PERTUTE I E ORTH- AND EMPLOYERS'LIABILITY I STA Y/N ANY PROPRIETOR/PARTNERJECECUTNE N!A EL EACH ACCIDENT N EX S OFFICEREMBER EXCLUDED? (Mandatory in NH) EL DISEASE-EA EMPLOYEE$ x yes,desrn;De UOFnder DESCRIPTION OPERATIONS below EL DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,may he attached it more space is required) CERTIFICATE HOLDER CANCELLATION • 111111 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 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Comotanonumaidir ofilfaxaveihusertY _ - = i Beams,MA 02114 2017 .�~ Workers'Comprimariat lasuranceAffiknib BeildersConeratiorsqBeetzieiztenThobers. TOER FILED W!lBlB_RIISSQ[ GAUiITY u64 on T:fie. mein= 06P--AovyanT_3-sc 4:)\-' ' F-,______________ _______ Are yea aa.,J.w re!c+k lteappmprTatenecc 7yPeG' _ I. ama=Omerwith -4.--- ecaioges{{ag s 7_ Ei New construction 2.01afaisirpeoporlorarpadaeslep wadbig far-maim & Qg zsg - .i 3-II laoiabomccvauardoi gag.nrltta INo.so t L7 �- �1 4.3m Ia:larearaerand. l ilibe egen�etcstoea�octagwodrmm�rpropedy.Zril1 100 adcrttnn ooze grata eagagagicemigaeriave.odLs'ao a iasereoceora resale 1.1„ElEkxtricat psis ar afka20315 peopoere unlattoemployes 12'Q • i01+mz icoolsadoradIi�el �c s&Sedaetbe hcdsiszL -y s or additions Thom have aapioyessamilmevessk ms�p. cez 13-L�r3j1 ofivo 6E1wesTe*c xpaaeicnaodasa ceshereessaae311SecrigFa m aramp� .cperMC am+—iO� I52.¢1(4),aaawa have aos[No Bodtas'caw iastanceroguivsl] I - - t*Any_FS ectlattl shasii>a.atalsofiilaut>irseraoals#rshoacegt rvafias'ceosicinatiourporear upon t tba selmitlizessifideritindoeiagniey=skins allw+orkalddrahirea>mietmneirer eat wa sur . omae=fr cieskt$ahmtmaatamet danidifei aatsiroetsbowi4Thesewofshest amdstatwLe3cor-natfimeeabitieshive employes Iftiesaircarisaesxshirreestployees,theytsaatptarideBr_z ira'comp.parley aunbrt Iawe aosearplayer that isprirla lairrtserizzece pie ore rforayemplo Below isticepracy watE mb=le In s u r an ce Cora p a ny Natix4-64M A 6060-(1)c-\- -(),(3 __T-,M 00 Polic Sdf . ((,10c)09)l hiCR1010R0 II 1 !p a) Job SiteAddress Cy Att &a cops of the orkers compensafitnapoNey declaration page(shaningthe poficy=sober aM evirutisa date). Fad to secure coverage as required alder it c.152,§25A is aexi l viohaimporrishoble by afneup to$1,50100 sorVor onelearimpriscennent,us well as eisHR peadtiesiu the form*fa STOP WORK ODDER mnda€ueeftugto$25000a day aiaSZ the violator.A copy of this slatonent may IbrwardedlotheOffieeofluvusti offfieD7Afume coverage _ Ioh ebyr r .the - - saf thattke prevideiaboeistnea�aorrectSim . t% c i i i 6 I _'-- Phonelk 6 s— ` - ? 7 OWick'11 use ou . Do►sat macis#isorrs:,tohe affspieted by cityer towno City or Tom Permit/. se i . Issue Authoray( ea* 1_Board of Health 2-$o ag Dot 3-City/Town Clerk 4.Electrical Impeder 5-Platothing Inspector 4 6.other Cont>et Pets=_ Phone ik AW RD CERTIFICATE OF LIABILITY INSURANCE DATE(M1 2M/DD0 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 WANED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCERCT S' Edson DeSouza MAYFLOWER INSURANCE GROUP INC PHONNo,Exti, (7/4)773-9702 FAX C,Nol: ADDREss, Edson@mayflowerinsurance.com 299 Court Street - INSURER(S)AFFORDING COVERAGE NAIC>f Plymouth MA 02360 INSURER A: HARTFORD UNDERWRITERS INS CO 30104 INSURED INSURER B: MNP CONSTRUCTION INC INSURER C: INSURER D 45 EXCHANGE ST APT 3E INSURER E: MILFORD MA 01757 INSURERF: COVERAGES CERTIFICATE NUMBER: 595621 REVISION NUMBER: THIS IS TO CERI IFY 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 POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POUCIES_LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS_ INSR ADM SUER POLICY EFF POLICY EXP LTR_ TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMJDDIYYYY) (MMIDDIYYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCEDAMAGE TO RENTED S CLAIMS-MADE OCCUR PREMISES(Ea oazmm1ce) $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATEPIRO- S POLICY , a LOC PRODUCTS-COMP/OP AGO $ OTHER AUrOMOBILEUABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY-AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED N/A BODILY INJURY(Per accident) $ NON-OWNED_ AUTOS ATOS PROPERTY DAMAGE HIREDAIITQS AUTOS (Per accident) UMBRELLALIAB OCCUR EACH OCCURRENCE S EXCESS IJAB CLAIMS-MADE N/A AGGREGATE $ DED RETENTIONS - $ OTH- WORKERS COMPENSATION X ATUfE ER • AND EMPLOYERS'LIABILITY Y/N , ANYPROPRIETOR/PARTNEWDX.CUDVE EL EACH ACCIDENT $ 1,000,000 A OFFICERIMEMBEREXCLUDED? NIA WA N/A 6S60UB1K70970620 11/16/2020 11/16/2021 (Mandatory in NH) EL DISEASE-EA EMPLOYEE $ 1,000,000 IT yes,describe corder DESCRY'1 rUN OF OPERATIONS below EL DISEASE-POLICY LIMIT $ 1,000,000 N/A DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only_Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by acrPssing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/Iwdlworkers-Compensationhirrvestigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Sexton Roofing &Siding Inc ACCORDANCE WITH THE POLICY PROVISIONS_ 102 Pine St AUTHORIZED REPRESENTATIVE Holyoke MA 01041 Daniel M.C y,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD AWR CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDIYYYY) 11/24/20 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 NAMe Art Calvillo PHOOne Family Insurance FAXN;.tel: 978-403-5942 we,.NI: 978-403-5943 1 Main St.Suite 15 EMIL DAD : artglfamriyinsurance.com Lunenburg,MA 01462 INSURER(S)AFFORDING COVERAGE NAIC IR INSURER A: Evanston Insurance Company INSURED INSURER B: MNP CONSTRUCTION,INC. INSURER C: 45 EXCHANGE ST APT 3E INSURER D: MILFORD,MA 01757 INSURER E INSURERF: COVERAGES CERTIFICATE NUMBER REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE US I Et)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.IMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADI)L SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSO WVD POLICY NUMBER ()IAM/DWYYYY),MU!DOJYYYY) LIMITS X COMMERCIAL GE+IERALUAElLrri• EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED pRIINIMtS(Ea oeeu„enu) $ 100,000 MID EXP(Any GM person) $ 5,000 A Y Y 3E 11385 11/20/20 11/20/21 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE IIMrrAPPUES PER: GENERAL AGGREGATE S 2,000,000 POLICY JE n LOC PRODUI.IS-COMP/OP AGG $ 2,000,000 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) S UMBRELLA IIAB OCCUR - EACH OCCURRENCE $ EXCESS IIAB CLAIMS-MADE AGGREGATE $ DPI) RETEN11ON$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE N/A EL EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? (Mandatary in NH) EL DISEASE-EA EMPLOYEE $ If yes,desenbe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additimsal Remarks S de,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 SEXTON ROOFING&SIDING INC ACCORDANCE WITH THE POLICY PROVISIONS. 102 PINE ST P.O.BOX 6327 AUTHORIZED REPRESENTA HOLYOKE,MA 01040 +45-3 . ( ©1988 2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD