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38-031
BP-2006-0396 GIS#: COMMONWEALTH OF MASSACHUSETTS .s _.. CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit# B P-2006-0396 Project# JS-2006-0577 Est.Cost: $3726.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: HOME DEPOT AT HOME SERVICES 126893 Lot Size(sq.ft.): 2439.36 Owner: FRENIER MELISSA Zoning: URB Applicant: HOME DEPOT AT HOME SERVICES AT: 61 CHAPEL ST Applicant Address: Phone: Insurance: 345 GREENWOOD ST UNIT 1 (508) 341-9401 Workers Compensation WORCESTERMA01607 ISSUED ON:10/11/2005 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL 3 REPLACEMENT WINDOWS 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 PER111T 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 10/11/2005 0:00:00 $25.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo , t„ * D-. ent useTonl ' City of Northampton ,-1, -� `2 it ,t'^' �K t a‹. s V 1l�Ca i uilding Department c " ` utt©tivew•a' r _ ..s f : �(� , -4, �� `� 212 Main Street Se ver e tit ,it t:xw.. t.`' Ai:1� Room 100 try eux :vaiIabi i ' � ..: OAT 1 2005 Northampton, MA 01060 hone 41 587-1240 Fax 413-587-1272 b tons' 1 t- , - !,iA Oth ,Reedy APPLICATION TONSTRUCT,ALTER, REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office . .-Map Lot - . Unit (--P _ 1 C \ St Zone Overlay District z EIm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: HAO\1%. --rD Jl iet Cp 1 C e( \ olikolpt5t, ow Name(Print) Current Mailing Address' 9 13 ' Telephone 3ignatuic 2.2 Authorized Agent: Nam (Print) Current Mailing Address: '1 ( C'l lL' 11/1tL1 u:� •iz% {'�il Lfc>I �13c `c �'r� j Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item - Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from(6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) iR5---. 5. Fire Protection 6. Total= (1 +2 +3+4 +5) 31240-- Check Number '95 3'J This Section For Official Use Only ' Date Building Permit Number. Issued: Signature: Building Commissioner/Inspector of Buildings Date Section 4. ZONING All Informatibn 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 I Setbacks Front I Side L: R: L:r- R: _' Rear r I f Building Height Bldg. Square Footage i % �— 1-----i 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 0 DON'T KNOW Q YES Q IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW Q YES Q ^IF YES: enter Book Page, and/or Document # B. Does the site contain a brook, body of water or wetlands? NO Q DON'T KNOW Q YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained Q Date Issued: C. Do any signs exist on the property? YES O NO Q IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES Q NO Q IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading, excavation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES Q . NO Q 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 I I Addition 1 1 Replacement Windows Alteration(s) Roofing Or Doors • Accessory Bldg. I I Demolition New Signs [CD] Decks [E] Siding [O] Other[O] Brief Description of Proposed » re pcame fi ^1 �,� r�S %1k 1r�t Work: 1 1'�� W ,IIXLL�' TVC� 1 Alteration of existing bedroom Yes No Adding new bedroom Yes 7 No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet Oa;If New house and=or ad"dition to exis ii ho.nsing compete the=o(owing: a. Use of building : One Family Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each 0 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 OR CONTRACTOR APPLIES� FOR BUILDING PERMIT / ( .�-1-foe _ , as Owner of the subject property �-•�J' hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application Signature of Owner Date I, 16 b r-a'•: I ((;11 , as Owner/Authorized Agent here y declare that the statements a d 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. tt. f C 11Gv' C � I ( I ( `( Print!i9me I L i L .1,'�,0L( S, I 5-1F315 Sigrra ure of Owner/Agent Date SECTION 8-CONSTRUCTION SERVICES r 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: License Number Address Expiration Date Signature Telephone 9�Regrst`ere`�'Homel>i�provemerSoico 's' Not Applicable 0 Cal Company Name Registration Num er T +D 14(.4 4 )t.cL� C S &/3/6 (" Address Expiration Date '3 S (k.,Vi,[4t 11(�',j��{�'� �� 1.;' 1j VL1L.. TelephonellOF'/ls` � 1i3 LA [IC 1 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 �l No 0 The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)families and to allow such homeowner to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor.CMR 780. Sixth Edition Section 108.3.5.1. Definition of Homeowner:Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two family dwelling,attached or detached structures accessory to such use and/or farm structures.A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time,during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152(Workers'Compensation) and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,you may be liable for person(s) you hire to perform work for you under this permit. The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Code,City of Northampton Ordinances,State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature • • 4giV�Yr p), ;- 0 4•.. A20 (riff f far lii3111pfoit a -- iFw E .51.s..dinsrlls' _-._._._„.._„.-7-,=,_-.—.—..-.-- T DEPA,RTMENT OP EUILO(?C INSPECTIONS t i 212 T4ain Street ' Municipal Building Northampton, Mass. 01060 WORICEIt'S COiYC['ENSATTON NSITRA1rCE Al,1.u) \ T I-., —___{.4 ` Q ��GPS _ .. . _ — - Qi permittcc) with a principal place of business/residence at: -- D (phone) SOO /'.1 6132 ( -ri& r_'Dp) do hereby certify, under the pains and penalties of perjury:, that • • ( ) I amn an employer providing the followinc worker's cornoensabon coverage for my employees worming on this job: ‘ AO i.u.an e 0, (JO (1) ' . . (L^s�r� Conte) (Policy Number) (Exptr� a zL) ' ( ) I am a sole proprietor, general contractor or hoaieoivmer (ciscie one) and have hired the contractors listed below wbo have the following worker's comnen_adon policies: (Nara: of Coot:nctor) (Insuranc.. CoinpaStyr?oiici Nu.m:Ds:) f xpli'Juon Datc) (Name of Contractor) (tnsuranc, Company/?o!icy Nuclb r) (Ex-piraon Date.) (Name of Courracior) ansuranco Company/Po1icy Nambef) (Expir tioo Date) I , (Name of Contractor) (Insuranc Comcwy/Policy Numb:r) (Expintion Dale) (na�,th t:ocsl t3caif ncocaa-)•to a-,duct=inform.loc pcZaiains to.11 - r ) . ( ) I am a sole proprietor and have no one world.ng for me. ( ) I am.a home owner performing all the work myself. NOTE:piece be:warm tt...,....:.lc bcco os.-ocn wbo czaple y pe-coca to So r-. �7,m c.�:.e.loo r rcpac wort on a d...ham`of got more thro thrr_tfa in w'cb the bowoorvocr resido or co Lilo rroaar r zppurtcort them c-r cot mar-Iry occi4d.-odd to he eisployes uwGc the.mc er's r .c-_-tioo Art(GLi152_a I(S))._,printion by.bom000va far:liczv or permit ray e.-idmrs(Sc Irgsl rto.3sc of no.splays coder the Wori xer compemation Ad... 1 undesr..ad ttut a copy of thin cat=cal m..y be fr..- dad to the Dock..nrrocar of 1.4 ,r d Aoo Off oo of trzw.00e for tb. covrrzsc vcireiioo.--td tru E lto- to serum`overt,,nd, yo^tioa 23 A of MOL 152 CU]red to the istoOsitica of ciminA PeoallhQ e"',,,-ic+-ts of z riot of t p to 11400.00 and/or°" alprtsoom C u cn oP to ooc yr_,cad c.11 pm,.hio to tx roan of.Star,woe c♦;Ord .ad• flag o(S 1••. 0o a thy Lcaiva me arte.�,+K 7 dig' / Perm For depit Numbest .[4 L,.O i.�p-w __ Lot Sit.. ,turcofLi crmiucc SEP-21-05 17:36 FROM-HOME DEPOT 6228 +860 286 5517 T-006 P.004/004 F-722 • .-v•..a.aL.a.a .....all,11tAt.I �_ Sold,Furnished and Installed by: Branch Name: ' 0 Sfb 1� Date: ?' t`�, THA.At-Home Services,Inc. • d/b/a The Home Depot At-Home Services /� 345A Greenwood Street,Worcester,MA 01607 Branch Number:�� Job#: /93 73 l a�y Toll Free(800)657-5182; Fax:508-756-2859 Fed oral ID#75.2698460 ME Lie f C 02439 RI Cont.Lick 16427 /� /, CT List,5/65522; MA Home Improvement Contractor Reg.4126893 • Installation Address: 6l L 19 .� �O 7/DA/! ' R1 " ,4 0/-0-4"D City State Zip Purchnsm'(a): Last 4 Dielta nr Driver's Lie.0& .Mo/Pr.- Work Plume: Dome Phone: ill el-1 S /erfiviel2 j ( ) ( ) (yid rt7 ta.19. Home Address: -- (If different from Installation Address} City State Zip Project Information: I/We/You("Purchaser"),the owners of the property 1 ocated at the above installation address,offer to contract with Home Depot U.S.A.,Inc.("Home Depot")to furnish,deliver aid amine for the installation of all materials as described on the attached Spec Sheet#: IA Q//� ,.incorp(rated herein by reference and made a part hereof. Home Depot reserves the right to cancel this contract if,upon re-inspec Lion of the.job,-Home Depot determines that it • cannot perform its obligations due to a structural problem with the bom-t or because work required to complete the job was not included in the contract. - • I IEPOSIT PAYMENT OPTIONS (r (Subj set to fund verification and/or credit approval.) CONTRACT AMOUNT,: $ 37y�,tp, 1. Cier�ayepl,t The.HomeDpot).k or US Postal erviceMoneyOrHar OAR e payahlo to The Home Depot). 1 ��f *LESS DEPOSTl s' -4 a-0'a 2. Credit Card•and/or other payment options-Circle Aac Below D(, �� QBALANCE DUE Visa MapterCard Discover American atomism � /'ge� ON COMPLETION $��St/((.) The Homo Depot Home Improve at Loan The Home Depot Cralit Cnr V 12. Available Crc lit:$ rat_ice(IinL&HDCC ONLY) �O/ *Minimum 25%of Contract Amount due upon execution 60 / !J j [ 7 of this contract. Acctif: 3]3 . if�,(y.��- ;3t Exp.Date:• Q/�' Name as it appears a r card;/- ig 1c 4 L , �''V l e Indicate Payment Method;li or *By my/our aignarun.below,Uwe agree to allow Home Depot to c rue th above BALANCE DUE ON FOMPLLTION: reface credit car.I f e epoait indicated. fU �ti t�iR4 dy Cardholre ate' . c�e-Ku0ZD • 1 / � 1-tt/ Gkl . • HI1.,or HDCC Authorization Codes De osit Final Payment # i 0 .,yLf # Purchaser agrees that,immediately upon satisfactory completion of the work,Purchaser will execute a Completion Certificate and pay any balance due: Purchaser also agrees to he jointly and severally obligated and liable hereunder. Entire Agreement:This agreement and irs attachments,including any finan:ing agreement,contain the complete agreement between the parties and can not bo amended or modified unless in writing in a separate agreement signed by both parties. NOTICE TO PURCIIASEJ, Do not sign this contract before you read it. You are ontided to a completely filler I-in copy of the contract at the time you sign. Keep , it Lu protect your rights. Do net sign.any Completion Certificate or,egreemcnt,s!aling that you are satisfied with the entire project before this project is complete. Law prohibits home repair contractors from requ siting or accepting a Completion Certificate signed by the owner prior to the actual completion of the work to be performed under thn contract. You may cancel this transaction at any time prior to midnight of the third busineis day after the date of this contract, See Notice of Cancellation for an explanation of this right. There will•be a service charge equal to 25% of the contract amount If the job 1s cancelled by Purchaser AFTER the third business day. BY MY/OUR SIGNATURE BELOW,I/WE AGREE TO BE BOUND BY TI-IE TER/IS OF THIS CONTRACT. I/WE ACKNOWLEDGE RECEIPT OF A COPY OF THIS CONTRACT AND TWO COMPLETED COPIES 07 THE NOTICE OF CANCELLATION. BY MY/OUR SIGNATURE BELOW, 'AVE UNDERSTAND THAT THE AGRE IMENT IS SUBJECT TO REVIEW OF MY/OUR CREDIT HISTORY AND I/WE AUTHORIZE HOME DEPOT AUTHORIZED COI'TRACfOR,TO VERIFY AND REVIEW MY/OUR CREDIT RECORD WITH AN INDEP NI)IINT CREDIT REPORTING AGENCY AND RELEASE THEM FROM ALL LIABILITY INCURRED FROM INADVF•TENT!� I'.;SIONS'OR ERRORS. DO NOT SIGN THIS a NT . CT IF THERE ARE ANY BLANK SPACES. I , L? Ir SUBMITTED BY: ..air �= Date:-___( .74 -Sal o isuyant ACCEPTED BY: %YI �I t.i,s Date: I ',a 0 Q icow aer i ____.� Date: - Homeowner • NOTICE:ADDITIONAL TERMS,CONDITIONS AND WARRANTIES ARE STATED ON THE itEVERSE SIDE AND ABE PART OF THIS CONTRACT While-Branch File Yellow-Customer Plnt-San Consultant 5.17-05 C-SC MARSH CERTIFICATE OF INSURANCE CERTIFICATE NUMBER ATL-000915907-02 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS MARSH USA,INC. NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE ATTN: ELIZABETH BRISENDINE (404)995-3568 POLICY.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE OR BRENDA BOOKER 404)995-2594 AFFORDED BY THE POLICIES DESCRIBED HEREIN. FAX(404)760-5768 COMPANIES AFFORDING COVERAGE 3475 PIEDMONT ROAD,SUITE 1200 ATLANTA,GA 30305 COMPANY 100492-IPUSA-GWA-03/04 A STEADFAST INSURANCE COMPANY INSURED COMPANY THD AT-HOME SERVICES INC. B ZURICH AMERICAN INSURANCE COMPANY DBA THE HOME DEPOT AT-HOME SERVICES,INC. HOME DEPOT USA,INC. COMPANY 2455 PACES FERRY ROAD NW C NEW HAMPSHIRE INS COMPANY BUILDING C-8 ATLANTA,GA 30339 COMPANY D AMERICAN HOME ASSURANCE COMPANY COVERAGES This certificate supersedes and replaces any previously issued certificate for the policy period noted below. 1 THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,CONDITIONS AND EXCLUSIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. COI TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR 1 DATE(MMIDDIYY) DATE(MMIDDIYY) A GENERAL LIABILITY IPR 3757 608-00 02/01/05 03/01/06 GENERAL AGGREGATE $ 4,000,000 X COMMERCIAL GENERAL LIABILITY 'LIMITS OF POLICY ARE EXCESS' PRODUCTS-COMP/OP AGG $ 4,000,000 CLAIMS MADE X OCCUR 'OF SIR:$1,000,000 PER OCC' PERSONAL&ADV INJURY $ 4,000,000 OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ 4,000,000 FIRE DAMAGE(Any one fire) $ 1,000,000 MED EXP(Any one person) $ EXCLUDED B AUTOMOBILE LIABILITY BAP 2938863-02 AOS '02/01/05 03/01/06 COMBINED SINGLE LIMIT $ 1,000,000 B X ANY AUTO TAP 2938865-02 TX 02/01/05 03/01/06 B ALL OWNED AUTOS BAP 2938864-02 VA 02/01/05 03/01/06 BODILY INJURY $ (Per person) SCHEDULED AUTOS HIRED AUTOS BODILY INJURY $ (Per accident) NON-OWNED AUTOS X SELF-INSURED AUTO PROPERTY DAMAGE $ 0HYSICAL DAMAGE GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY' EACH ACCIDENT $ AGGREGATE $ A EXCESS LIABILITY IPR 3757 608-00 02/01/05 03/01/06 EACH OCCURRENCE $ 5,000,000 X UMBRELLA FORM AGGREGATE $ 5,000,000 OTHER THAN UMBRELLA FORM $ C WORKERS COMPENSATION AND 5899472(AOS) 02/01/05 03/01/05 X TOW LIMITS 1 OER EMPLOYERS'LIABILITY C 5899479(AOS) 03/01/05 03/01/06 EL EACH ACCIDENT $ 1,000,000 E THE PROPRIETOR/ X INCL 5899477(NY,WI) 02/01/05 03/01/05 EL DISEASE-POLICY LIMIT $ 1,000,000 PARTNERS/EXECUTIVE ARE: EXCL (NY,WI)ERSIEXECUTIVE E OFFICERS 5899484 NY,WI 03/01/05 03/01/06 EL DISEASE-EACH EMPLOYEE $ 1,000,000 F OTHER WORKERS 5899475(AZ,ID,MA,MD,OR,VA) 02/01/05 03/01/05 F COMPENSATION CONTINUED 5899482(AZ,ID,MA,MD,OR,VA) 03/01/05 03/01/06 D 5899473(CA) 102/01/05 03/01/05 D 5899480(CA) 03/01/05 03/01/06 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS • CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL an DAYS WRITTEN NOTICE TO THE FOR INSURANCE PURPOSES ONLY CERTIFICATE HOLDER NAMED HEREIN,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE,ITS AGENTS OR REPRESENTATIVES,OR THE ISSUER OF THIS CERTIFICATE. MARSH USA INC. / . BY: %�• -t4-a.-1.A.7;Yokeiti+- MM1(3/02) VALID AS OF: 02/01/05 • DATE(MMIDDIYY) ADDITIONAL INFORMATION ATE-000915907-02 02/01/05 PRODUCER COMPANIES AFFORDING COVERAGE MARSH USA, INC. COMPANY ATTN:ELIZABETH BRISENDINE (404)995-3568 OR BRENDA BOOKER 404)995-2594 E ILLINOIS NATIONAL INSURANCE COMPANY FAX(404)760-5768 3475 PIEDMONT ROAD,SUITE 1200 COMPANY ATLANTA,GA 30305 THE INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA 100492-IP USA-GW A-03/04 INSURED COMPANY THD AT-HOME SERVICES INC. G N/A DBA THE HOME DEPOT AT-HOME SERVICES,INC. HOME DEPOT USA,INC. 2455 PACES FERRY ROAD NW BUILDING C-8 COMPANY ATLANTA,GA 30339 H TEXT WORKERS COMPENSATION POLICY#5899476(TX) POLICY PERIOD 2-1-05 TO 3-1-05 CARRIER NEW HAMPSHIRE INSURANCE CO.. WORKERS COMPENSATION POLICY#5899483(TX) POLICY PERIOD 3-1-05 TO 3-1-06 CARRIER NEW HAMPSHIRE INSURANCE CO. WORKERS COMPENSATION POLICY#5899478(QSI) POLICY PERIOD 2-1-05 TO 3-1-06 CARRIER AMERICAN HOME ASSURANCE CO. CERTIFICATE HOLDER FOR INSURANCE PURPOSES ONLY MARSH USA INC.BY Page ol/liaadaclutaeigt Board of Building Regulations nr,d Stan I:•lis t €I— L HOME IMPROVEMENTCON(RACTON Registration: 126893 Expiration: 3/3/2006 Type: Supplement Card THE Home Depot At-Home Servic RICHARD FALLONE 3200 COBB GALLERIA PKWY#20 ALTANTA,GA 30339 { Administrator I