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23D-107 (37) fi ' ' BP-2006-0424 GIS#: COMMONWEALTH OF MASSACHUSETTS ,, ii b4y CITY OF NORTHAMPTON s`:.`Lot:-001 Permit: Building Category: BUILDING PERMIT Permit# BP-2006-0424 Project# JS-2006-0627 Est. Cost: $88753.00 Fee: $445.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Centrimark Inc. Lot Size(sq. ft.): 53143.20 Owner: 548 ELM STREET LLC Zoning:URB Applicant: Centrimark Inc. AT: 548 ELM ST Applicant Address: Phone: Insurance: 6 Avenue E (508) 435-0999 HOPKI NTONMA01748 ISSUED ON:10/21/2005 0:00:00 TO PERFORM THE FOLLOWING WORK:Replace Main roof per construction specifications submitted POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: FeeType: Date Paid: Amount: Building 10/21/2005 0:00:00 $445.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo e , Versionl.7 Commercial Buildinc4_Permit Ma 5.2non D el:i gittietlfirS76-76/i ly , 1 City of Northampton StaiuS of Perrnit: _. Building Department Curb Cut/Driveway Permit - - . - 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability - Northampton, MA 01060 Two Sets of Structural Plans . phone 413-587-1240 Fax 413-587-1272 Plot/Site Plan Other specify APPLICATION TO CONSTRUCT,REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION 1 ;SITEINFORMATION. _This section to be completed by office -IA Property Address: _ i CALtirtJ Coot-106e tZt-riAtato rivito..) Ce.yr611- 1 *(1 -0 7.3 I) it; '-_- to-/ Unit '..i-•..,:qi. ii.,..-,,„,.- i 5,-IS CLA-i 6T . I No ell-vir mp-ro>-3 ,•rut A. 010 6 0 i li.,..... ' `I-Efi-ii St b4 IrP-, -_-:-TCB:dittfial• m--..„,,,,,,,„,Wr,r SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT . _ 2.1 Owner of Record: - , Name(Print) s1-46- R0,3E2,175, Current Mailing Address: , t _ Signature Telephone 2.2 Autho ' e i . Name(Print) ,/ Current Mailing Address: Signature 7 Telephone 1 SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building ! liR5?,15-3 00 (a)Building Permit Fee 2. Electrical i (b)Estimated Total Cost of Construction from (6) 3. Plumbing . l Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total=(1 +2+3+4+5) 4?)er i 7 .7.3 0 6 Check Number _1 ',-,..allis Section For Official Use Only Building Permit Number'. ' ' Date -Issued Signature: - Building Commissioner/Inspector of Buildings Date r. ,- `' 1• Versionl.7 Commercial Building Permit May 15,2000 SECTION'4-CONSTRUCTION SERVICES FORPROJECTS`LESS THAN 35,00 CUBICFEET•O.F ENCLOSED:SPACE ' Interior Alterations ❑ Existing Wall Signs El Demolition❑ Repairs❑ Additions ❑ Accessory Building❑ Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing E/ Change of Use El Other❑ { Brief Description !Enter a brief description here. Of Proposed Work:y . 1 jZG-r 4_ of-t0,i/ Exis: (�1J +2ocE. 'ro Ebe. - Ia5'tVNtr}?ic• GF- 042.A..) EP6m.$1.51.61"-‘. 1 SECTIONS-USEGROUP AND CONSTRUCTION TYKE ' USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly A-1 0 A-2 0 A-3 El 1A I ❑ CI _ _ A-4 0 A-5 ❑ 1 B 0 B Business 0 2A 0 E Educational 0 2B ❑ F Factory El F-1 ❑ F-2 El 2C El H High Hazard ❑ 3A ❑ I Institutional )R1 I-1 El 1-2KI 1-3 0 3B a 0 M Mercantile 0 4 ❑ R Residential ❑ R-1 0 R-2 El R-3 El 5A ❑ s Storage El s-i ❑ S-2 ❑ 5B l ❑ U Utility ❑ Specify:I M Mixed Use 0 Specify:? S Special Use 0 Specify:I COMPLETETHIS:SECTION IFEXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS'AND/OR CHANGE IN USE Existing Use Group: 1 Proposed Use Group: Existing Hazard Index 780 CMR 34):I 1 Proposed Hazard Index 780 CMR 34): 1 1 SECTION 6BUILDINGHEIGHT=AND:AREA - BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION # t....„ .J... = ��, Floor Area per Floor(sf) 7,zt- ,„,...„... - ,,., , 1st ; f 1 1 �r , ,,,,.,,,..,17.„..,,,„...,..-4,,,,tri '"� p 0,—, t^ 2nd � ate; " v ..,E a `.; Total Areas Total Proposed New Construction(sf) —,, Total Height(ft) 1 ' ' �� Total Height ft 1 I ' - , 3 7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public ❑ Private 0 Zone! 1 Outside Flood Zone❑ Municipal 0 On site disposal system 4. Versionl.7 Commercial Building Permit May 15,2000 �0&'i'IFTi�11 O�T`'zoNwG-L- r„ Existing Proposed Required by Zoning 0,✓ This column to be filled in by /� Building Department Lot Size I i 1 Frontage Setbacks Front 1 j Side L:' 1 R:----� L:�i R:{ ' I 7 T, Rear BulIdmg Height . ; i =_ Bldg.Square Footage (— % I 1 1 Open Space Footage (Lot area minus bldg&paved I-1 ( i i I I 1 I parking) I I I i 77 #of Parking Spaces Fill: ' ! I i (volume&Location) i' A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DONT KNOW a YES 0 ' IF YES, date issued: j j IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW `e) YES IF YES: enter Book Page; and/or Document# B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW 0 YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained © Obtained Q , Date Issued: C. Do any signs exist on the property? YES 0 NO e IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES ® NO Oc IF YES, describe size, type and location: I I E. Will the construction activity disturb(clearing,grading,exca ation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 ' NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. t � } Version1.7 Commercial Building Permit May 15,2000 SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780-CMR 116(CONTAINING MORE THAN 36,000 C.F.OF ENCLOSED-SPACE) 9.1 Registered Architect Not Applicable 0 Name(Registrant): Registration Number Address IExpiration Date Signature Telephone 9.2 Registered Professional Engineer(s): Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date I I i Name Area of Responsibility i I Address Registration Number I i Signature Telephone Expiration Date Name Area of Responsibility i I j I ' Address Registration Number Signature Telephone Expiration Date I I Name Area of Responsibility Address Registration Number I I 2 Signature Telephone Expiration Date 9.3 General Contractor CAN'[I nit H vt:c. 1200(=1.) I Not Applicable ❑ Company Name: C % 't(S iZ Ggb�o.) Responsible In Charge of Construction Si ( LI`i- 1.0Se E /100e/ .tL G I Address i /foe 5,90 07061 ture Telephone Versionl.7 Commercial Building Permit May 15,2000 SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) -- Independent Structural Engineering Structural Peer Review Required Yes 0 No r SECTION 11-OWNER AUTHORIZATION TO BE COMPLETED WHEN "Y OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING`PERMIT ` // I, as Owner of the subject property hereby authorize to act on my behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date I,j ,as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Print Name Signature of Owner/Agent Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder:; J �� ►aG�� 0`6. v 7 -7 License Number Address Expiration Date ...ad, 1 - SZ3- Z187i Sig ture Telephone SECTION 13-WORKERS'COMPENSATION INSURANCEAFFIDAVIT(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 0 r i ' aZ ltAar nT I- - �‹) '� t. 5 E (rif- of �orflluiltpfoii I — g c"! rJr �tcsIRrhncctta' • - DEPAtRTMENT OP EIUIWING INSPECTIONS el, — 212 Main Strcct ' Municipal Building Northampton, Mass. 01060 WORKER'S COMPENSATION, L`tSUSNC AFIU)A{{IT • • I, ---- - — --- _-._.—- (licens Jpermittcc) 3.1..i b_2 p inn nil nl-•re 1businessJrsIdencc 21: _ -(phone) (st c/city/staicr]p) do hereby certify, under the pains and penalties of perjury, Thai . ( ) I am an employer providing the following Worker's compensation coverage for my employees working on this job: • (Ln_curL Company) (Policy Number) (E,:pirrion Date) ( ) I am a sole proprietor, general contractor or homeowner (circie one) and have hired the connactors listed below who have the following worker's coopensadon policies: (Name of Contractor) (Insurance Company/Policy Nl1tT c ) (Ex trd::on Date)"- (Name of Coorracior) (th.surancc Company/PoLicv Nuriccr) (E uai on Dale) , (Name of Contractor) (Dance C.ompao}•/Polio}' Nurnb`r) (Expimdon Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Dale). 4 (acich_diitioc al 6,-c ifoeoescry to cacui infcxma.'ioo pertaining to.1l cone--won) t 1 • ( ) I am a sole proprietor and have no one work ng for me. ( ) I am.a home owner performing all the work myself. NOTE:plea be"-lit the•aria bomco•+vcra..-bo emplay peutna to do m••rt.-, ecs,:e,o c repair work an a dwelling of not more th t',.t-ve tmR,in wb,d,the bomoowtacr raidoo or CC the p-retyna z9puutrv-rs thew e'r we C'11y onenietv-reI to be otployc-a orcla,the..vciriz o-a•pr-.-•lion Ac (GLt52 e 1(5)),application by a booave far c licenne or p,.,wt rr_y cvidmcc the Iega1 niyc or an e,ployx under rho Wortc-0!a C,ompom.lioa.Act I undo-Tutu!dui e copy or thi,mtcmoot may b.for...uded to tbo Dctwramoo of Io,k••',id Acodcoia'ofGoo or Ira.r-"'co tar ha coverage vaiCelion and that Litaac to some'coverage tmdcr soczioo 2 5 A of MOL 152 da lead to the i=2,A ion of criminal pen-whirs oomin;isg of a rune of up to S 1_300.0o andror impriloozcocza of up to one year and evil p-a.ltie,in be form of a Stop Wort Orde cad■ rim of 3I00.00 a day[gavial Inc. For doge e t u.c only Permit Number Mapes—_ Lot Signature of Lia�scc/Permittcc L)3te .-__ .i • i s 4444 Construction Specification ► � ► � Calvin coolidge rehab center 548 Elm Street Northampton,MA 01060 Specifications For A CentiMark EPDM Fully Adhered System Sections included:Main Roof Project Preparation: Perform a pre job meeting to determine jobsite logistics and safety requirements. Safety Related Furnish and install proper safety equipment and adhere to appropriate safety practices for all roof level obstacles. Such obstacles include,but are not limited to skylights,suspect structural decking areas,and open perimeter edges. Furnish and install proper safety equipment to identify and restrict unauthorized entrance into areas associated with ground related roofing activities. Store roofing materials in accordance with good roofing practices. The loading and placement of materials will be in a manner as to distribute weight loads uniformally over the entire substrate. Stored rooftop materials will be covered and wrapped by packaging and/or tarpaulins protecting them from elements and potential loss,until their use is needed in the construction of the new roof assembly. Surface Preparation: Remove and dispose of 11913 square feet of existing roof system(s) and related debris down to the primary roof system and a workable surface. The primary roof will be spot cored for deteriorated/wet insulation. If any is found, it will be removed and replaced at a unit price of$3.00 per square foot. The area of existing roof assembly removal will be limited by the area of new roofing that can be installed on any given day. Inspect existing structural decking for deterioration. Structural decking not capable of providing a proper substrate for mechanical fastening or other essential roof assembly requirements shall be removed.Appropriate deck material shall be furnished and installed at a unit price of $2.00 per inch per foot. The amount of deck replacement will be agreed upon by client's representative prior to removal. Remove existing perimeter drip edging and dispose of. Remove the existing perimeter termination bar and dispose of. Remove existing wall flashings down to a workable surface and dispose of Insulation Attachment: Furnish and install a layer of 1/2"high density,coated 6-sides,fiberboard insulation, (R-Value= 1.39). This layer of insulation will be mechanically attached to the prepared substrate utilizing FM Global(FM) approved 3"plates and fasteners. CentiMark Confidential r Install insulation boards in a staggered manner with no gaps greater than 1/4". All gaps in excess of 1/4" must be filled with like insulation material. Furnish and install a new wood nailer along the outside perimeter to meet the thickness of the new insulation. The new nailer will be secured utilizing FM Global(FM)approved fasteners. System Application: Furnish a CentiMark 45 mil,non-reinforced,EPDM roofing membrane. Position the EPDM membrane over the newly prepared substrate and allow the membrane sufficient time to "relax" prior to installation. Install the new EPDM membrane by directly adhering to the prepared surface utilizing a bonding adhesive. The adjacent and "up slope" membrane shall overlap by no less than 4". Overlapped areas shall be treated with an application of primer wash and sealed with a 4"butyl-based seam tape. HVAC,Curbed Penetrations and other Air Handling Unit Details Furnish and install a 6" wide laminated reinforcement perimeter strip at the base of the curb. Attachment shall be done by means of a 1" wide polymer batten bar or 2 3/8" seam plates that are mechanically fastened at a maximum of 6" on center. Fully adhere the EPDM membrane up the curb using a bonding adhesive. All corners will then be completed with uncured EPDM rubber flashing. • Furnish and install 30"x 30"protection pads at equipment service door panels. Furnish and install 30"x 30"protection pads at roof access points. Parapet Wall Detail Furnish and install a 6" wide laminated reinforcement perimeter strip at the base of the wall. Attachment shall be done by means of a 1" wide polymer batten bar or 2 3/8" round seam plates that are mechanically fastened at a maximum of 6" on center.Fully adhere the EPDM membrane up the parapet wall using a bonding adhesive.Furnish and install an aluminum termination bar as outlined in Sheet Metal Accessories. Pipes Less Than 6"In Diameter Furnish and install new prefabricated rubber pipe boot where applicable. The boot will be secured at the top with a stainless steel screw type clamp and sealed.The base of the boot shall be fully adhered to the field sheet. Stacks Greater Than 6" In Diameter Furnish and install 60 mil,EPDM uncured flashing,where applicable. The uncured flashing membrane will be field • fabricated in either a wrap or box method. Regardless of method used, each flashing layer will be overlapped, and have independent flashing pieces covering joints. The flashing will then be rolled in place to ensure proper adhesion. Miscellaneous Projections Furnish and install a 60 mil,EPDM uncured flashing to the roof projections. The uncured flashing shall be installed in a redundant manner at all transition points. Transition points include, but are not limited to corners and points where horizontal surfaces intersect with vertical surfaces. Furnish and install a lap sealant,urethane-based mastic,or two-part EPDM-based sealant to detail projection as field conditions require. Furnish and install new pressure treated wood supports and protection padding under conduit lines, gas lines and freestanding units where necessary. CentiMark Confidential • 1' Sheet Metal Accessories: Furnish and install retro-fit drain insert(s) complete with new clamping ring and debris basket into existing drain leaders. The retro-fit drain seals will then be compressed against the existing leader inner wall. Any internal plumbing work to connect drain insert(s)or make corrections,will be performed at owner expense. Furnish and install a water-block mastic sealant to all existing,newly prepared/installed drain(s). Furnish and install our aluminum fascia bar at the edge of the membrane adjoining any applicable open or closed perimeter(s). A water-block mastic sealant will be applied behind the membrane before the bar is installed. The fascia bar will be secured using FM Global(FM) approved fasteners,fastened every 8" on center. Furnish and install new 40 mil, mill finish aluminum gravel stop and/or drip edge and underlying cleating system. The type of edging used will be determined by existing or new created slopes and means of drainage. All metal flashings will be secured using FM Global(FM)approved fasteners,fastened every 8" on center. Standard Operating Procedures: Employee Professionalism • All work shall be performed in a safe,professional manner in compliance with all industry,recognized regulations. Permits CentiMark will supply the necessary permits for the project. Nightly Tie-In's Dependant on new roof system being installed, temporary water cut-offs are to be constructed at the end of each working day to protect the newly installed roof system, and building interior from damage due to wind, snow, and rain. Clean Un All work premises will be cleaned daily during the construction process and at the completion of the project. Job Acceptance and Punch List Conduct a post job walk through for final sign-off of our job completion form. Warranty Upon purchase of the roofing system, you become entitled to receive the benefits of single source responsibility through CentiMark's comprehensive written warranty. This warranty protects your roof against defects in materials or workmanship. If your roof leaks at any time during the warranty period, we will provide complete warranty service. Quote Name Section Name Length Fully Adhere EPDM Main Roof 20 CentiMark Corporation is not responsible for pre-existing conditions including, but not limited to; structural damage or deficiencies, clogged drains,mold growth, excessive standing water, removal of hazardous materials or other hidden deficiencies such as; damaged or leaking skylights, HVAC units/conduits, electrical or gas lines, re-calibration of satellite, lightning protection systems or landscaping. It is the building owner's financial obligation to provide corrective measures. Also, due to unforeseen conditions and/or interruptions to our work schedule at the customers request,additional charges may be incurred. Recommended Accessory Options to Consider: None CentiMark Confidential 1 4444 Executive Proposal Summary ► Calvin coolidge rehab center 548 Elm Street Northampton,MA 01060 Valid from 10/10/2005 to 10/31/2005 Quote Section Sq.Ft. System Warranty Price Fully Adhere EPDM Main Roof 11,913 EPDM Adhered 20 years* $88,753 *Roof system warranties protect your roof against defects in materials or workmanship for the specified period as outlined in the CentiMark Non-Prorated Limited Roof Warranty or the manufacturer's warranty. Options for Quote:Fully Adhere EPDM Section: Main Roof • None For internal use only,ID# 11157 Project Manager Signature Date Standard terms: One-third (1/3) of the contract price due at the job start and the balance due net thirty (30) upon job completion. (Special terms are available upon request) The quotes appearing in this Proposal have been calculated based on current prices for the component building materials. However, the market for building materials is considered to be volatile, and sudden price increases could occur through no fault of CentiMark. Since the quotes are material terms of this Proposal, CentiMark exclusively reserves the right to revoke, without written notice, the quotes at any time prior to a valid purchase order or fully executed contract. • CentiMark Confidential .-in-t--411-i•-•------w4x6r.Plegirstaik3Paggi,770747. 41 ,,,,,,,, ,..,..„..,,,„...-,,,,,,,,fq,,t.m.:: 777.-..5•3rie.;.,:#6,Fii.:473..ue•TQC•dAid,..;$44,‘%,-.,j#:P.:$!•egkegf,,:rPti(,,,l.'i:',..'''.."',',,:•;:1,';',,• -...,4,A'.-744,,igitratArarliAlle 7'41,1471*,,,trge$4.1.2047.it,A;W::•i*.i•i VI ....,O,t'f:,'Irl..711p..44-....,'rq•T;'1-tRi,4•7"1.'""0.; .`'.,'''' i• ' •f!.,..'.t.•4';.:;:-;-',4"tt.,:.,tt 4:7..,..,,...• , •.o,.,r, w,rii.r•-•-,.i,i',.....-4',41iijoil'41.`1,TrIt'cii:::',',,I.:44i041,4.,..41,.4,,•W•,,,t'%'','.1'1,!•.1,„:‘.„i,,,,,,,..4„-$:,..,4„;;•,;•,,,,,.. ..1.:,,,,,,,,Q.;:f..'14,t:,':,, .-,•,,,,.,'„,4:;"'2,',.'..tt.P.:1',.:•••,:•,,,,,;,,e..:'..' ...-...,.....•,,,,,,t.. ,'‘.. ..._ r :., , ‘4.''t'4:•?.:Iir,*7-iP-:r,R.'•';17.,;•-j'kf.,rif.'''."`fr.'.*,.1':',14-1 •Z•''':.:-....:•t''.' 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',.4-,-.:-..-,.... .,..,;,*,-,,,,.. A...v., ::•.,.. ..h••-s,r7-4,A••••,,v- •D ,,'.•,• ,viti.-1,,h.w...i-: • -,:••,,;,,-:::,•',.-•:.,: .-i-,,-- •c:. • •$.• 1„-.,,,,,,,,,,:,—,•,..,•,•., -- , . •-,,..... •3•-•.t•-•._ .,....- ks'. .'4,..C:';7 4i;:l.-V53.:.''if:::1`,' '., ,.....'':,.1P..r l'Ai•tt,"....4.:'ti,,,....,„,..,-ZAW4 i 1- , 777' ,-I:.A,ti•-,•:,..g.;1,10- 6.,, ,, :;..., ,...--•.. 4F-.--tara.- --1- 17,-,t I F.,,,,, : - -----;•.•:...-..-xV.,,. •,ji'. , 0,1',',4;4,-!-- •,: ,.-...---':7:..::.Ft;,-,-,e.,: ':cit•rAr...41,w4.:,-..•,. •-,p-,•-wt ---...,o, .• ,, -- .. .....,--i•07,,,f- 04,--,, ,.:• . 1M :3-• ::-.-4--,•-•-et-,-,,ii, '• , : - -, !A ,, -,-----• - .,, •gt-a..-,-,, , Penthouse ,....±. x . . . .., . . • . kwt-- vs5 -33 • .„::._.,. OCT-19-2005 WED 12:42 PM CENTIMARK • .- — FAX NO. 1 508 435 0110 P. 01 CENTIMA1 RK I t.. MARK )/ Ent:e l.!I Nei IN ROOF SYSTEMS MA►SSACHUSE1TS :r) t' DRI •'S 6 , . S08974118 7,4 = N DOTE OFOI TN GUILE, RSV HOOT sex •< ' 05.24-1976 0 S-07 In `': ` wwwcenfimark.com , `?', James Best 05-2 05-24-2008 , [TEST • i °Prruna:hfanaaer JAMES E 6 Avenue E 20 BERNARD-RD Hopkinton, MA 01748 WOBURN,MA 01e0•691aevor eoc 888.523.2187 'FA Tn omco 508 435.0999 rat 508 435 0110 Nationwide: 1.800.558.4100 tc`wnoaneaea4 . './ aeaa ud BOARD OF BUILDING REGULATIONS '.:License: CONSTRUCTION SUPERVISOR , Number 080749 Bit> lta`lp6124/19T76 E*pltias: 1r5/24r2005 Tr.no: 80749 • Rost,eri004: <00 JAMES E BEST 20 BERNARD RD EZ-..47-4-eriscs,Y . WOBURN• MA 01801 Administrator ACORDTM CERTIFICATE OF LIABILITY INSURANCE Page 1 of 2 10/18/2005 PRODUCER 412-586-1400 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Willis of Pennsylvania, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 444 Liberty Ave ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Four Gateway Center Suite 505 INSURERS AFFORDING COVERAGE NAIC# Pittsburgh, PA 15222 INSURED Centimark Corporation INSURER A: Continental Casualty Company 20443-001 12 Grandview Circle Canonsburg, PA 15317 INSURERS: INSURER C: INSURER D: INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRL IINSR0 TYPE OF INSURANCE POLICY NUMBER POLICY (M EFFECTIVE POLICY UNITS A GENERAL LIABILITY GL2057296119 5/1/2005 5/1/2006 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE ES(Eaorencel $ 100,000 CLAIMS MADE X OCCUR MEDEXP(Anyoneperson) $ 25,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 5,000,000 POLICY X JECOT LOC A AUTOMOBILE LIABILITY BUA2057296122 5/1/2005 5/1/2006 COMBINED SINGLE LIMIT $ 1,000,000 X ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULEDAUTOS (Per person) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EAACC $ AUTO ONLY: AGG $ A EXCESSLIABIUTY L2082396391 5/1/2005 5/1/2006 EACH OCCURRENCE $ 1,000,000 X OCCUR CLAIMS MADE AGGREGATE $ 1,000,000 DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND QQSTAT��JJ OTH- EMPLOYERS'LIABILITY TORYLIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE EL.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? • E.L.DISEASE-EA EMPLOYEE $ Eyes,describe under SPECIALPROVISIONSbelow E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Division/Location: Rocky Hill, CT Office #1100 Re: 2600041400 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Calvin Coolidge Rehabilitation Center REPRESENTATIV• 548 Elm Street AU ORIZEDR ENTATIVE Northampton, MA 01060 ' ACORD25(2001/08) Co11:1436072 Tp1:424700 Cert:63 778 ©ACORD CORPORATION 1988 CONTROL NO. 1 308674 CEPJTIMA RI THE MARK OF EXCELLENCE IN ROOF SYSTEMS Vendor Address Chec�C CITY OF NORTHAMPTON MASSACHUSETTS Document : 1500194764 212 MAIN STREET Date : 10/18/2005 NORTHAMPTON MA 01060 Telephone : (800)-558-4100 Your Vendor Account # : 35035132 D4Cu rent V ur dgcument Data Deductions cross amount 3900469285 PERMIT 10/18/2005 0.00 445.00 Sum total 0.00 445.00 :....>:;::: ::*:*.Tr*: ****.......... >:::>Q:3