Loading...
31B-111 (2) BP-2021-2031 11 BRIGHT ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 31 B-1 1 1-001 CITY OF NORTHAMPTON Permit: Exterior Res PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit # BP-2021-2031 PERMISSIONIS HEREBY GRANTED TO: Project# ROOF Contractor: License: Est. Cost: 13893 MASTER ROOF INC 194771102403 Const.Class: Exp.Date:03/06/202311/20/2022 Use Group: Owner: VEREBAY AMY Lot Size (sq.ft.) Zoning: URC Applicant: MASTER ROOF INC Applicant Address Phone: Insurance: 9 WILDWOOD DR (774)287-0202 6562UB 1 K80621721 MILFORD, MA 01757 ISSUED ON:10/14/2021 TO PERFORM THE FOLLOWING WORK: 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. Signature: • r , >2 . 3-11 Fees Paid: $40.00 212 Main Street,Phone(413) 587-1240,Fax:(413)587-1272 Office of the Building Commissioner RECEIVED The Commonwealth of Massachusetts Board of Building Regulations and Standards OCT 1 31Licipuiy POR � ) Massachusetts State Building Come, 7 30 CMR . E S Building Permit Application To Construct,Repair,Reno ( IN tq ECTi ised Mar 2011 One-or Two-Family Dwelling NORTHAMPTON.MA 01060 This Section For Official Use Only Buildin Permit Number: 1 -) )• pU 7/ //Date Applied: • 'cult...) (.2).5 Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION • 1.1 Property Address: \ 1.2 Assessors Map&Parcel Numbers 1 1 1 v (�%A S� • 10 oiNha µ� 1.1 a 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) Front Yard 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 0 Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 cwner1 of Record: .� Oh �, O 5Aevex\ MacrVea V) y O< \\A 1 1 Name(Print) J City,State,ZIP F��� N‘S�� a, 860- oq 16so No.and Street Telephone Email Address . SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description f Proposed Work2: S�NAV dk NG. —toM- 16�el O.c. 6A - 1-%%•.`D420t -\ DZ N ookA„, Spa-\e, SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 13, gq3• q 1 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ ❑ Standard City/Town Application Fee ❑Total Project Costa(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Suppression) Total All Feis0� 1 Check No.Nil Check Amount:440 Cash Amount:_ 6. Total Project Cost: $ 1?. 893 0 Paid in Full 0 Outstanding Balance Due: • • SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) C5— WZ.LA �n tea' kZ x t 20 ( � License Number Expiration Date Name of CSL Holder • R `1 ��tom\ t•C . List CSL Type(see below) v No.and Street c Type Description o,r.1 S,t.1, Unrestricted(Buildings up to 35,000 cu.ft.) R Restricted 1&2 Family Dwelling City/Town, tate,ZIP M Masonry RC Roofing Covering • WS Window and Siding I 9 Z tt OZ o L w,1 c1 t,,��a\rc I pp� SF Solid Fuel Burning Appliances C� �I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) ,9 y 1T h I 03-06-23 0. C Q-' I h HIC Registration Number Expiration Date HIC L C mpany Name or C Registrant Name p ‘ A h IN T 8 - Son Q c 0Q . CO"s•-•- No.and Street Email address 0 0 AS"i t-I TH ?bv-1 o'Z oZ. City/Town,State,ZIP Telephone • SECTION 6: WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L. c. 152.§ 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes No .❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize II 5p cl \c&\.c . to act on my behalf,in all matters relative to work authorized by this building permit application. c 4a e czy4 CcD'R c c-c* AO-OS- Print Owner's Name(Electronic Signature) Date 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 application is true\and accurate to the best of my knowledge and understanding. 1 I doh DcX Cep C�-O 5-21 Print Owner's or Authorized Agent's Name(Electronic Signature) Date NOTES: 1. 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 not have access to the arbitration program or guaranty fund under M.G.L.c. 142A. Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 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 t N r`- �� % Massachusetts ' DEPARTMENT OF BUILDING INSPECTIONS 1. • `!' 212 Main Street • Municipal Building tea' Northampton, MA 01060 1SNyy � 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: Z �rS�� s A • wow aA e ` q- O 16 / O The debris will be transported by: Name of Hauler: S Vrx or W�`J ` A 2 • Signature of Applicant: XI ka'(\ �/� �- Date: l0 - OS 2 .:*ateagia zatto*.a.24,1 ._ , . . ..... . 43414aki '9 vill-salkall'311.!quield"'5; soisadvill Irm'IsPiltli 1' lull img.010!,111` trco'vaLl'edK1 Zu!STilfali''l 'ililigAill le Polon 'A ! :two",iiiip)ispiegallls Z1%0.1.404'41' . P!'"11,1V1.11111 141 31'rvtl 1 AO ' ',10f.4110 iiii$101 -10 Jtiu 141 p4mi1servi.3...Iq At'YRAtl,V.Itift ilt!MILitat sew 49q Imp"rt p.spii16 , • 2020 1-, '2. k L 14 :r4'N11(1441 ‘),oc- .1,1,,,,,,,,,,,,p,,,,,,Rulv!;more',Nom/rood stiolavatatrisvf,Aryp ov.4,krArtifd.,44 fo s:approtml pieta ckurrAd Asiol'AMON 41/111.4”Cop ht.N pp y isc1lIlir:391.0 X/IIIIIMOVIV,14 4131 via lig'p NIIIIIMIrill'F, NIWII',ifl A:INI144)19.0a ImpwAruoji ,4:1M11 JUVIriuMnr"'Srlfl Jo /-1''V l'crfill'ill'‘'741111 rC"1"'"I'e '41/4'171r ir laKrOcZi"11'613A1 A41.1i ri,I II:Knit() N31.AA 401S'r..go'curl Jill null'smultrio,d IP Alc"4m IPA`s'e 11ULL/156111(VCIEL141111 1817'3- 'lltikl V/Pm' 010.06‘11S on do 74i111.4'r'4141 IHriroun4 mon 1"11414.k Ilmanno le'RI vitzl-,72ca ---, 1961i IL'Ili"in r,inunitk14*E xii":"Oe,"'AUT1-17 '1.1 n4111'07-.4 •laver irsimppii,dho pow.sairomme ixived Alp tAop!trowir0 allied orepiaspap imp!!maspossadmias.sialpieva mile illets et wow 090 1 0 -ildrld 1)0 k,ir -4‘34\..)0 cA / . — . ...-2 2 1 h2 f I Q 'moll:LI' ti,.1-,i 1214 12,0 % -z ()g 9 4-.241'ca1111."'S/0• Ailfs,p14 ' ramp, uv 111-ttrate , lire!Wronalicse! Aprqpripira kirm I aigr vq,ssopry NWRJCoyelaw,.1411.4goi.fixtrasiiitglif sisprogodstistcp,,uoyd,o2t4 Segiplitit q stir.saiegthro itiff ism I zNeurots Al.rumcnii Jr ,,41,161006 rot"NI N,-31,..!,t,:natt ,,7.91'...w,g-tiitar.$iNnitproarmossernqiirK...1.41 si `VINif,tdiV111 A,,Ill'SAVIVICA 1,4,111/1 innu ao iripi,*..29rit,rirr,aor;le lawn 1P,.1V ao moum inf15,3,1fr413‘'I"or 110404111Prr"v1RaiirrInk friniul%,,R1'011113MP'NV'42,Vravao..)-, 17001DRI1clxf,u"'im vlitItru',lawn Intruiels;Prim savIlwrIvoENN,Trsloo lrooq ilintr cow rovkk er aittrior.Arr S..A90 Siaiorivisi Loorirrivr'sew]pimp;AV%141,4k41.4011111,4141 -umpritmumgan e;:ntpdi rune ir.ruihiairo,C1cipir.1%Irraill..5riikso In.oviryi gacarr.r.-K Nip ono in°Ira!prim ii#11.41.4121111p mr9fa ruirmighliir 140y4, I ri .1,li,f34.%ft.,jP:ollffix"ii;:liusa 71.:7:743;ibuw4-4 41 Atiri;73:::t rxx.'N"744,lAr.17.1.:4161r4.7,11,yo:1147::: 14,71;: il%-\.) ILVO n-q ,,,,eb.3 ,.x.7rIAPJAWKIII 1,1411144.41(7111,11., ritl pur Cni,N10/14;"4,urni'Faf4POTIften:',,r% 2, st 7•%39.1 , l'inV,PVTIfTtilr NI(Lin irlArar,4611J,VVItill,-gin%74141 Toni{ rof I rue souseupiwo onnasIO v mar a L',...„.; 1,1„,,,a 1,-,E1,, ,fliteaA0 3,3,9,, nk F-J.,zr, -x-iotitta..,eitt top nk•coopt.,r.atAbd motiorre go,:miltubil ir-A10411711 L'it II .-1"Aur um somorrn•attrt aworIM61:4611tail,,,,rprawt.AtIng tarr,.u.opnrigro,or ilonfE 411441114 orm n '1;111„xliutc41 ritai 4WD 100,4,ITIC V14,14107,IRIIVIVICIECINIM:hum:NA tri%rue ampr,amongli v.um li Lim FW"rarTIPIV imp:RINI L its II ,,i[lritillwif 31.141010tIVE Avev,i,,,IV,711-41 4,,Q,V, F.403 140,4 or.Amur 11.1a VotlYnconip r‘iar. lowitillimuncr up..itturhm 12eutimr,ttla-.4utt,t,,witany,tos,1.•iiimnrirr,itor. AW11111101=111 D -14 4111 MItti'PM dittrp0114,V.441;VIOIVL,Ale A1.4114 irwr nirrtmEwtrfirchtl 10 aoi4V4 Iii(1441"Iter4 V'Mr ri Et-: . tortopinareaki:11 t--N C -,L .ymurri-ond OM tram ring 1,c-fuoi:orrditai.7. q grO tV,1V41;4111AVV,K'eare ti tit it Ipairalbaur$ts.sfaamd le id iii :1,01 ittetmo.,4ir Mil vow)zritiourellevo or WWI:*mi. '3:11Z',3111P(IS 4411) 29 2 CD 1_,9,2, 1-, 14 1-4, '''''' 3"41'd k-ASL ko \ck .„---,— -- -- \A!Tho 1--1 \--‘7.,k : ,,.- npv ----)v, ._. — o 4:51s 7 , . liftripm:pul ktettrtrittsr-ii i-....,catliitcrrila il;•au.rr,?N _).a \g-10),-.1 Arro.1 31414,11 Ahr.atd . toiNyr In.1 i4j,111 1 jar Aq,(11,01, A.11,1111(111I I\ ')\I I I 11\111A.1 "flit fill I%01114 1114(CI likaapuntild Nonmi.apie nairt..to,ct I.-0 t:a ita ci,).-x4.1 i,1!rim :it!,tt:pi!,!v a act Aletsiul otelo clot'xiinto, ,vriari f 0•‘•t, ay9 .t e 1 X'S'119-1411i..01,41t,e14 , • [61/0 t •RPOIS' 'i,I)iiS'S''N.,-0..ba'lii:1 j I Njudp!,),71-'fri7.1.1,,?quit fo ,14,3.14.Yii•rtdda 1,41,41111 1 t,.s I,I i 10 rpip,-,,ltiou.0144(1,3 rikeii ,..K..-- . . • S ROOFING CONTRACT HIC#:194771 44q: RI LIC#:36719 MA LIC#:102403 09/21/21 DATE: fiti REPRESENTATIVE Diana Zapata • ROOFING•SIDING•REPAIR WNW.masterroof.com SOURCE MR • GENERAL CONTRACTOR'S AGREEMENT(The"Agreement") I/We,the Homeowner(s)or Owner(s)of the premises described below,hereby authorize Master Roof Inc.(the"contractor")to furnish all necessary materials,labor and workmanship to install,construct and place the improvements described herein according to the following specifications,terms and conditions on the premises described below. OWNER'S NAME Steven MacLeay COUNTY ADDRESS 11 Bright St CITY .Northampton STATE MA ZIP 01060 CONSTRUCTION SITE CRY STATE ZIP HOME PHONE WORK PHONE ALTERNATE PHONE E-MAIL (860)309-7650 I ( ) SHINGLE COLOR QUANTITY DIAGRAM OF HOME•EAGLEVIEW TIMBERUNE HDZ TIMBERLINE ULTRA HD AMERICAN HARVEST • • • TRUE SLATE SKYLIGHTS DESIGNER WORK TO BE DONE: 1 MASTER ROOF,INC IS NOT RESPONSIBLE FOR DEBRIS IN THE ATTIC, 40 TEAR OFF LAYERS• ADDITIONAL SHEATHING(PLYWOOD)MARKET PRICE PLUS$30 LABOR OR •,EI REPLACE SHEATHING IF DRY ROT IS PRESENT $7.50 LINEAR FOOT OF LEDGER BOARD,ADDITIONAL LAYERS ARE$40 ZI USE GAF WEATHER STOPPER SYSTEM(ACCESSORIES) PER SQUARE PER LAYER ,(fl INSTALL GAF TIMBERUNE HDZ ADDITIONAL WORK: ❑INSTALL NEW CHIMNEY FLASHING AND BOOT PIPES Install 1/2"plywood over existing roof decking ❑RE-FLASH SKYLIGHTS JOB SIGN IN YARD • , J REMOVE ALL JOB-RELATED DEBRIS ,fl MANUFACTURER'S WARRANTY • In ADDITIONAL CONSTRUCTION EST.START DATE: EST.START DATE: SECURITY INTEREST: YES 0 NO PRICE $ 13,893.91 DEPOSIT WITH ORDER $ 4,200.00 Personal or Bank Check Payment Method SALES TAX $ BALANCE TOBEPAID $ 9,693.91 ON COMPLETION 13,893.91 Financed by TOTAL DUE $ BALANCE TO BE FINANCED $ This Agreement is subject to financing which you must secure within thirty(30)days of this agreement.If financing acceptable to Master Roof,Inc is not obtained within 30 days,this Agreement may be cancelled by either party. All home improvement contractors and subcontractors must be registered by the State of Rhode Island and/or State of Massachusetts registered by the Chief Administrator of the Massachusetts Board of Building Regulations and Standards.Any inquiries about a contractor or subcontractor in relation to registration should be directed to State of Rhode Island and/or State of Massachusetts Office of Consumer Affairs and Director of Home Improvement Contractor Registration. The Contractor shall obtain and pay of the building permit and other permits and governmental fees,licenses and inspections necessary for proper execution and,completion of the Work. If the Owner elects to obtain the foregoing permits,or to deal with unregistered contractors,the Owner will be excluded from the guaranty provisions of N.H.G.L c 542.The Owner shall obtain and pay for all other necessary approvals,easements,assessment and charges. The Contractor and the homeowner hereby mutually agree in advance that in the event the Contractor has a dispute concerning this Contract,the Contractor may submit such arbitration as provided in Massachusetts/Rhode Island General Laws. 9 23 2021 HOWEOWNER'S SIGNATURE DATE CONTRACTOR'S SIGNATURE DATE Notice:The signature of the parties above applies to the Contract of the Parties to alternative resolution initiated by the Contractor.The Homeowner may initiate dispute resolution even where this section is not signed by the parties. No work shall begin prior to the signing of this Contract and transmittal to the Owner of a copy of this Contract.This Contract constitutes the parties'total agreement.This contract may be amended or supplemented only by a written change order signed by the Owner and Contractor.All surplus material is property of Master Roof,Inc. NO ORAL AGREEMENTS ARE ACCEPTED �(///!�rd INITIALS DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Homeowners)may cancel this transaction at any time prior to the midnight of the third business day after the date of this transaction. IN WITNESS WHEREOF,the parties have hereunto signed their name this day of 20_. PRINTED MASTER ROOF REPRESENTATIVE SIGNED OWNER SIGNED MASTER ROOF MANAGER SIGNED OWNER AMI2f) CERTIFICATE OF LIABILITY INSURANCE DATE(MM/D D/YYYY) 05/17/2021 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 CONTNAME ACT Sarah Waters D FRANCIS MURPHY INSURANCE AGENCY INC PNC.No.EMI: (978)568-8711 F X,N,): E-MAILDRSS: swaters@dfmurphy.com 133 MILFORD ST INSURER(S)AFFORDING COVERAGE NAIC# MEDWAY MA 02053 INSURER A: ACE AMERICAN INSURANCE CO 22667 INSURED INSURER B: . MASTER ROOF INC INSURERC: INSURER D: PO BOX 83 INSURER E: MILFORD MA 01757 INSURER F: • COVERAGES' CERTIFICATE NUMBER: 656290 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER LIMITS (MM/DDJYYYtn (MMIDDJYYYtn COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ • GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ OTHER:' $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS N/A BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE N/A AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X STATUTE ERH AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 A OFFICER/MEMBEREXCLUDED? N/A WA WA 6S62UB1K80621721 01/24/2021 01/24/2022 (Mandatory lnNH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS/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 accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/Iwd/workers-compensation/investigations/. • CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Master Roof ACCORDANCE WITH THE POLICY PROVISIONS. 124 Main St AUTHORIZED REPRESENTATIVE Milford MA 01757 Daniel M. Crowley, 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 Q+: DATE(MM/DD/YYYY) AC RD• CERTIFICATE OF LIABILITY INSURANCE 5/17/2021 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 Dennis F. Murphy- Medway PHONE 133 Milford Street rac.No.Ext): 508-422-9277 (rac,No):508-422-9914 Medway MA 02053 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Nautilus Insurance Company INSURED MASTROO-01 INSURER B:Mapfre Insurance Company 34754 Master Roof Inc. PO Box 83 INSURER C: Milford MA 01757 INSURER D: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:899254120 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD VD POLICY NUMBER (MDD/YYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY NN1234039 3/10/2021 3/10/2022 EACH OCCURRENCE $1,000,000 DAMAGE TO CLAIMS-MADE X OCCUR PREMISES(EaENTED occurrence) $100,000 _ MED EXP(Any one person) $5,000 PERSONAL&ACV INJURY $1,000,000 • GEN'L AGGREGATE LIMIT APPLIES.PER: GENERAL AGGREGATE $2,000,000 POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ B AUTOMOBILE LIABILITY BBKL69 12/13/2020 12/13/2021 (Ea aBceiGeDtSINGLE LIMIT $1,000,000 ANY AUTO BODILY INJURY(Per person) $ OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS y HIRED y NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident)* • $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ • DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Master Roof 124 Main St Milford MA 01757 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD • 4, Board of Building i :�,; Consi bhi jl rvtsof CS-102403 63pures:11/20/2022 WILSON R VALDEZ j 9 WILDWOOD`DR MILFORD MA411757 � C /f ' y: `� • • Commissioner c)gat4121i'. bi&ndia.. • ./. Off.of Consumer Afters L Ousews%Rsount on ROME IMPROVEMENT CONTRACTOR Registration valid for individual use onIy TYPE:Ccano-aaot before the aspiration date. 1f found return to: • Reatf4ition F70Uatiop Office of Consumer Affairs end Business Regulation 194771 03'06/2023 One Ashburton Place-Suds 1301 MASTER ROOF INC Boston,MA 02108 WILSON R.VALDEZ 124 MAIN ST .__... MILFORD,MA 01757 h Underseuetary • ' .; vali;f,' ithout signature