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11-012 (7) 110 MORNINGSIDE DR BP-2021-1508 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 11 -012 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-2021-1508 Project# JS-2021-002505 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.): 30012.84 Owner: WEISENTHAL AMANDA L Zoning: Applicant: SEXTON ROOFING CO AT: 110 MORNINGSIDE DR Applicant Address: Phone: Insurance: P O BOX 6327 (413) 534-1234 WC HOLYOKEMA01041 ISSUED ON:6/17/2021 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. i � , iy9 4.) Certificate of Occupancy Signature: I FeeType: Date Paid: Amount: Building 6/17/2021 0:00:00 $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner .....__..._. . A. The Commonwealth of Massachusetts ".0111 ' Board of Building Regitlaiions and Standards MUNICIPALITY LITY Massachusetts State Building Code,-780 CMR,7 edition USE BuildingPentiit Application To Construct,Repair,Renovate Or Demolish a RevisedJartfru One-or Two Family Dwelling 1,20 This Section For Official Use Only • Building Permit Nu er: P .QJ- /ore- Date Applied: .iL U Signature: L- 2oz a Building Commissioner/Inspector of Buildings Date Ca '' .e SECTION 1:SITE INFORMATION V `� <o 0 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 1 • 1.1a Is this an accepted street?yes no Map N umber Parcel Number m • oo 1.3 Zoning Information: 1.4 Property Dimensions: o 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 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public❑ Private❑ Zone: , Outside Flood Zone? Municipal❑ On site disposal system 0 Checks if yes❑ • • SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: r A a�oA t,t-) e f S e�T h tc-e. • Ho 1440.c h , n, 4'v.•� p.,e • Name(Print) Address for Service: • • C Lr�c,1' 4-14 d • q,7-57d -/(o3. Cfs-Yte,ha(G(2,Pit /5'41e ‘"/s f"v, • • - Signature Telephone f • . SECTION 3:DESCRIPTION OF PROPOSE'}WORK2(check all that apply) .New Construction❑ Existing Building gl/ wner-Occupied - 1lepairs(s) ❑ Alteration(s)'Q Addition ❑ • Demolition ❑ Accessory Bldg.❑ NumberofUnits r Other 0 specify: Brief Descrip on of Proposed Work: • 4rycziu vt-a* • lcr� Era_�.-� cS/ i..-Li.„ , - • . SECTION 4:ESTBIATED CQNSTRTJCTION COSTS • • Estimated Costs; Item • Official Use Only (Labor and Materials) • 1.Building $ I, Building Permit Pee:$ Indicate how fee is determined: • ❑Standard City/Town Application Fee 2.Electrical $ ❑Total Project Cost/(Item 6)x multiplier . x 3.Plumbing . . $ ' 2. Other Fees: $ ' 4.Mechanical (HVAC) $ List: _. - 5.Mechanical (Fire Total At1 Fees:S `V • Suppression) Check I‘Z i Cheek Amount Cash Amount: 6. Total Project Cost: $ t 2, C2 . ,- l7 Paid in Full El Outstanding Balance Due: 0 SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) 91 U! 16/2,1 Ere -e i/ .S'e,tir ' License Number icaavti Dace Name �of CSL Holder Q'� 7 JC_} V <LJ(-�}K ({JL1Q'7 List CSL Type(seebetow) L/.J Njo.aand Street[ p }�y��J i {� Type Description t/V tl eA e . f t 4- j�/O (-� U Unrestricted(Buildings tqa to 35,000 cu.ft) R Restricted 18r2 Family Dwelling City/T State,ZIP Masonry RC _Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances I _Insulation — Telephone Email address D Demolition _____- Si Registered Home Improvement Contractor(HIC) J / 9 3 7 n gc�c)i� dna's1di/ ._Tn : 1�a 9-� HIC Registration_Number £aspiration Date HIC Co cry Name or egistranu Name f7 vt 1` x E la3,z /rn7 h(th)7Q(/C� j I No.and Street E ii address rn/9 d//J-'i q13-5.34--� City wu,State,GIP Telephone SECTIONS: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 ' 'I(' 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 3g f tf) !i ct �!a I Ll)C to act on my behalf in all matters relative to work authorized by this builditiaermit appiication.'J nl� r ohioehprI /' I i2_aL Print Owner's Name(Electronic Sigznanse) D SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION By entering my 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_ /IZ1? f MUST BE SIGNED by Owner or Authorized Agent Date NOTES: I_ An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will ad have access to the arbitration program or guaranty fund under M.G.L.c 142A Other important information on the H1C Program can be found at www_rmass_gov/oca Information on the Construction Supervisor License can be found at w«v_mass_�ovfds 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 Sxs... :. c Massachusetts ? r 1 t DEPARTMENT OF BUILDING INSPECTIONS !' '' h" `7 212 Main Street • Municipal Building Northampton, MA 01060 tsi .` CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, 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: 71*2 )f/ J)-- 14) f 4. (,10 The debris will be transported by: Name of Hauler: 5i,z , Ie/ C� (.11 c?A7*G.#.4 5 Signature of Applicant: Date: ( 4 L/z-/ ne t.ommonweatat of massacnusetes Department of Industrial Accidents Office of Investigations Lafayette City Center 2 Avenue de Lafayette,Boston,MA 02111-1750 www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leeibly 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 employees(full and/or part-time).; have hired the sub-contractors 6. ❑New construction listed on the attached sheet. 7. 0 Remodeling 2_El I am a sole proprietor or partner- ship and have no employees These sub contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' q ❑Building addition [No workers'comp.insurance comp.insurance.: r ] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ 1 am a homeowner doingall work officers have exercised their Plumbing myself. 11.0 repairs or additions [No workers'comp. right of exemption per MGL 12.0 Roof repairs insurance required.]* a 152,§1(4),and we have no employees. [No workers' 13.0Other comp.insurance required.] 'Any applicant that checks box 41 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. Contractors that chock this box must attached an additional sheet showing the name of the sub-contractors and state whether or not thaw entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. l 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 Casualty Company of America Policy#or Self-ins.Lic.#:7PJUB-0G07898-2-21 Expiration Date: 6/4/21 Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under 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 insurance coverage verification. I do hereby certify under the ns and penalties of perjury that the information provided above is true and correcL Signature: — Date: Phone#: 413-534-1234 Official use only. Do not write in this area,to be completed by city or town ofjiciaL City or Town: Permit/License# Issuing Authority(check one): t—1 I❑Board of Health 2❑Building Department 3❑City/Town Clerk 4.13 Electrical Inspector 5rd'lumbing Inspector 6.0Other Contact Person: Phone#: DATE ` A�C_CP E) CERTIFICATE OF LIABILITY INSURANCE z` o err) Ni , THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS GERIIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CEKIIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING 1NSURER(S), AUTHORI7FT) • 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 CONTACT NAME Ormsby Insurance Agency,Inc. • (ar PHONE_Eztl: (413)737-0300 I Fw,No); (413)737-0617 698 Westfield Street E-MAIL ADDRESS: • West Springfield,MA 0.1089 INSURER(S)AFFORDING COVERAGE NAIL 3F INSURERA; Colony Insurance Company 39993 INSURED INSURERS: Sexton Roofing and Siding Inc INSURER C: 102 Pine Street INsuRER➢: • .Holyoke,MA 01040 INSURER E: • INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CEN I IFY THAT THE POLICIES OF INSURANCE US I tiJ 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 1S SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES_LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS_ INSR SUB: POLICY EFF POLICY DO. LIMITSL-yR TYPE OF INSURANCE yyvp POLICY NUMBER . (ME/DD/Y r TT)•(MM/DD/T I Y), A X COMMERCIALGENERALLIABILTIY 101PKG002159905 6/25/2020 6/252021 E4CHOCCURRENCE $ 1,1)00,000 DAMATO RENTED , CLAIMS-MADE X OCCUR PREMISEES(Eo occurrence) S 100,000 MED EXP(Any one pecan) S 5,000 PERSONAL a ADV INJURY I s 30,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE I S 2,000,000 X POLICY JET I LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: S. AUTOMOBILE LIABIL TY COMBINED SINGLE LIMIT s (Ea accident) • ANY AUTO BODILY INJURY(Perpeson) S • -ALL OWNED SCHEDULED BODILY INJURY(Per accident) S • AUTOS AUTOS ' • NON-OGVNED PROPtK 1 Y DAMAGE S HIRED AUTOS _AUTOS _ (Per acdde d) S UMBRELLA LIAR OCCUR EACH OCCURRENCE S - EXCESS LIAB CLAIMS-MADE AGGREGATE S ➢ED I RETENTIONS S WORMERS COMPENSATION - I ATUTE CITH- ER AND EMPLOYERS LIABILITY Y/N ANY PROPRIETOR/PARTNERJE;ECUTIVE j 1 N/A EL EACH ACCIDENT S OFFICER/MEMBERsxcwoED? J(Mandatory in NI-I) EL DISEASE-EA EMPLOYEE b If es,desa be under - DESCRIPTION OF OPERATIONS below EL DISEASE-POUCY LIMIT S DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,AddNiorral Remarks Schedule,maybe 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 ACCORDANCE WITH THE POLICY PROVISIONS_ • AUTHORIZED REPRESENTATIVE • I I ©1988-2014 ACORD CORPORATION_ All rights reserved_ ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD P ._drf T Baastors,14 02I14-2027 _ rolls wr1x a - ApplientlacormOon Please Print Leeibtv Nalme 03,6kiesockE2422600theifidue rn p ( o u n c_ A! ASex,Ob@ 1 q_\, Are roaaaaa `Cfcerkrieappcopcisxbe= - ofcI-• r. _ Laj '��acapi rycr- tszipicric* s 2.0Iamz soicp aoidar Yrrdiag formeiE r8 II R "mg 31:11ama doing ail ay-Jr3f No uvulae asap.; 11 • bm ai�6c} g s:oao a�magpm ty.Z� 1 10El1 n . on a.0Iana ease tataif cazaziaarseitherkeremmarce aaren icanszsce-aramsaic I in FlethithlISoraf► ns i asr3hmanpio}as 12 - S_❑Imax I 3fasal-cav camttcat r-Iv .— . - s 7bsSe Ism cropioy linceserrio.a;:e.!i4itnp i„mint i -- 6.[j we�: ia- a Lore t of p=1 c_ - 14II oi§er 154§1{ ardwciaaveniataQla}ces[No 'aam¢im* I - - - xAuy'apy�tdia�."� m�:FnliHmr�rsectia+8dotr ocr. tF3cxmco rnraailo - sc doing ailirackattirkeethiecart6rst=izaitaiicirafficlarkiixfcatiegstri ltantndors fast ciezktbisbmcm.staamciedaau7raoomaisVSisiour the amenftile dsiostaha3carnatSmcnxtiticsborc employees_ Mlle they tssstpm:itk/kiri- cceopiporcy valicc I sm tut employed tis rc�Jrrs'� f a Below Estkr walla s t V\k t)1 0014«Ufl QJ3 J. CIO zns �y 1„ Po cy#o f- . # (ONo 9111)10gt} O EspimtionEt4= I11 link 1 Sob ,-AiStatdap: Attach a copy of the werkers'compensation go *declarationpage fshraugtistp zed expiration- date) • Failure to=came coverage as=Fired inch rIgli.c 152,NSA is aciiminal VioldinarponisMIc byafroe up t o SI,500_00 andtor one-yeir iiMiriibrimeatiswdIasriYRticnal siuthefarmtsfaSTOP W URDEE3nda flue oftpto5250M0a (ay a rc vio1a ur_A copy of this'th-tatter may be forwarded to the Off=afinvestigaticins uflheDIA for insurance coverage 3a _ I di)herdyam�a /rsie asd also tketirain a rprassieisbereasaem�!tos:red Si aixre �, "� - p [ ' IIG / - n) ` City ar Tor= # - 7ssu E�ti1loT1 (cii[lam o I I_Board of Iletith 2111al >3epartmcat 3OtylTownClerk 4-Electrical Inspector 5..112mthiaglospector 6-Other ! - - Coniat#Pe sore_ Phoneme j AE CERTIFICATE OF LIABILITY INSURANCE DATE" ) 11/13/2020 .\ 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 CONTACT NAmE Edson DeSouza • MAYFLOWER INSURANCE GROUP INC No mil, (774)773 97o2 iw*,a> DDS: Edson@mayflawerinsurance_com 299 Court Street INSURER(S)AFFORDING COVERAGE NAM# Plymouth MA 02360 ENSURER A: HARTFORD UNDERWRITERS INS CO 30104 INSURED INSURER B: MNP CONSTRUCTION INC rNSURmc: INSURER D: 45 EXCHANGE ST APT 3E INSURER E: MILFORD MA 01757 wsuRERF: COVERAGES CERTIFICATE NUMBER: 595621 REVISION NUMBER: THIS IS TO Cf_KI iFY THAT THE POLICIES OF INSURANCE US 1 I=U BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR COND(TiON 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 CONDmONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRY EFF POLICY EXP LT ADMTYPE OF INSURANCE NSD WSUVDR POLICY NUMBER Po�IYYYY) (YM/DD(YYYY)_ MOTS LTR MSD IMTruLTD COMMERCIAL GENERAL LIACIUTY • EACH OCCURRENCE S CLAIMS-MADE OCCUR DAMAGETOa PREMISES((EaEa RENTED occurrence) $ MED EXP(Anyone person) $ N/A PERSONAL BADVINJURY $ -GENL AGGREGATE UMrTAPPLIESPER • c' GENERALAGGREGATE $ POLICY IR& LOC • PRODUCTS-COMP/OP AGG $ OTHER_ $ • COM AUTOMOBILE LIABILITY (Ea m nt11NGLEl1MIT $ ANY-AUTO BODILY INJURY(Per pecan) $ ' — AU_OWNED —SCHEDULED AUTOS AUTOS N/A BODILY PLURY(Per acdderd) $ — — NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Per accident) $ UMBRELIALIAB — OCCUR EACH OCCURRENCE S DICES LIAB CLAIMS-MADE N/A AGGREGATE S DED RETENTIONS $ WORKERS COMPENSATION X ATLITE OTH- ER • AND EMPLOYERS'LIABILITY Y I N ANYPROPRIEroRlPARTNER/E(EIITNE EL EACH ACCIDENT . $ 1,000,000 A OFFICERIMEMBERDCC UDED? I wA( NIA NIA 6S60UBiK70970620 11/16/2020 11/16/2021 (Mandatory in NH) EL DISEASE-CA EMPLOYEE $ 1,000,000 IT yes,describe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMITS 1,000,000 N/A DESCRIPTION OF OPERATIONS I LOCATIONS I VS-OGLES(ACORD 101,Addfional 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 B3 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(unleoo 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 arp'sing the Proof of Coverage-Coverage Verification Search tool atwww.mass.gov/Iwd/workels-compensationrfyestigations/. 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_ Sexton.Roofing &Siding Inc 102 Pine St AUTHORIZED REPRESENTATIVE - 7. Holyoke MA 01041 /D" E CL Y I Daniel M.Cry,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD OlYYYY) Acc1 DATE(YlllO RL' CERTIFICATE OF LIABILITY INSURANCE „n4JDN THIS CERTIFICATE IS ISSUED AS A MA I I tK OF INFORMATION ONLY AND CONI-hNS 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),AUTHORI7FT) • 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 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 endotsernent(s). PRODUCER poste Art Calvillo One Family Insurance rrivccN+ En): 976-403-5942 {arc rmj: 978-403-5943 1 Main St Suite 15 ra=a0 3: artg1fannlyinsuranc_e_Com Lunenburg,MA 01462 INSURER(S)AFFt:MDALG COVERAGE NAIC S INSURER A: Evanston Insurance Company INSURED INSURER B MNP CONSTRUCTION,INC. INSURER C: 45 EXCHANGE ST APT 3E INSURER e: MILFORD,MA 01757 INSURER E INSURER F: COVERAGES LLRTIFICATE 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 PER I AIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR INSD WVD POLICY NUMBER MIDCY EFPYY POLRDYYIP r LTR TYPE OF INSURANCE {15A DIYYYY) (Nu1fODlYYYYL LIMITS X COMMERCIAL GENERAL unBa rY EACH OCCURRENCEDAMAGE TO RENTED 5 1,000,000 CLAIMS-MADE X OCCUR PRETAIS Eaoex m ce) 5 100,000 MED EXP(Any ana person) 5 5,000 A Y Y 3t i 9385 11/20/20 11/20/21 PERSONAL&ADV INJURY $ 1,000,000 GENT_AGGREGATE LIMIT APPLIES PER: GENERAL_AGGREGATE S 2,000,000 POLICY P LOC PRODUL.IS-COMPEER AGE 5 2,000,000 -OTHER 5 AUTOMOBILE LIABILITY COMBINED SINGLE Uldrr (Fa accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUIUS ONLY AUTOS ONLY (Per accident) S UMBRELLA LIAR OCCUR —_ -- EACH OCCURRENCE S EXLesS LIAR CLAIMS-MADE AGGREGATE S CED RETENTION 5 S WORKERS COMPENSATION —�- PER OTH- STATUTE ER A27D EMPLOYERS'LIABILITY Y/N ANY PROPRIETORIPARTNER/EJECUTIVEn N!A El_EACH ACCIDENT S OFFICER/MEMBER EXCLUDED"! 1 (Mandatory in NH) E_L.DISEASE-EA EMPLOYEE $ [Tyres,describe under DESCRIPTION OF OPERATIONS below ,ELDISEASE-POLICYLIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES (ACORD 101,Additnarral Rrsrrui6 Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCFI I Fn 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 AUTNORIZID REP£tEs1=NxTA HOLYOKE,MA0104D /3T ©198E-2015 ACORD CORPORATION. Al]rights reserved. ACORD 25(2016/03) The ACORD mine and logo are registered marks of ACORD DocuSign Envelope ID:4970FA37-CD34-4C6A-86B9-68960A506FD9 firopolsat SEXTON ROOFING AND SIDING INC www.sextonroofmg.com IKOP.O. Box 6327 Holyoke, MA 01041 Setting the Standard ,Avaim w�c p. 413.534.1234 f. 413.539.9906 MA HIC# 118239 sextonroofmg@hotmail.com SUBMITTED TO Amanda Weisenthal PHONE 917-5821633 DATE 5/19/21 STREET 110 Morningside Dr amandaweis1991@gmail.com CITY,STATE,ZIP Northampton,Ma. Field Remeasure 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. (white/brown) 4) Install ice and water shield on eaves(6'), vent stacks, in valleys, chimney, and at intersecting roofs. 5) Install synthetic roofing underlayment 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. 10)Reflash chimney as needed @$300.00 11) Supply manufactures Lifetime warranty and SRC 5 yr.workmanship warranty. ATTENTION HOMEOWNERS:PLEASE COVER ALL PERSONAL BELONGINGS IN THE ATTIC,GARAGE,OR STORAGE AREAS DUE TO POSSIBLE ROOFING DEBRIS OR DUST COMING THROUGH CRACKS OF WOOD DECKING. We Propose hereby to furnish material and labor-complete in accordance with the above specifications,for the sum of Twelve Thousand Eight Hundred DOLLARS 012.800.00) PAYMENTS TO BE MADE AS FOLOWS: due in full upon completion All Material is guaranteed to be as specified. All work to be completed in a Authorized workmanlike manner according to standard practices. Any alteration or Signature twiati WU`.,- deviation from above specifications involving extra costs will be executed only upon written orders,and will become an extra charge over and above the estimate.DAMAGES TO BUSHES AND OTHER VEGETATION'MARKS ON HOUSE MAY Note:This proposal may be withdrawn by us if not accepted BE UNAVOIDABLE AND WE ARE HELD HARMLESS. Not responsible for water within(14)days. damage during construction. Owner to pay responsible legal fees for non- payment,and applicable interest. attrigatitt of Fropoliial The above prices,specifications ', , and conditions are satisfactory and are hereby accepted. You Signature a$itllLt�Ut WU are authorized to the work as specified. Payment will be made as outlined above. Signature Date of Acceptance.