Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
24C-096
BP-2023-0421 73 MASSASOIT ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 24C-096-001 CITY OF NORTHAMPTON Permit: Alts Renovations Repair PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit # BP-2023-0421 PERMISSION IS HEREBY GRANTED TO: Project# RENO 2023 Contractor: License: Est. Cost: 74000 107919 Const.Class: Exp.Date: 09/24/2023 Use Group: Owner: TRUSTEE MELLEN KATHLEEN A Lot Size (sq.ft.) Zoning: URB Applicant: THE TUCKER GROUP LLC Applicant Address Phone: Insurance: 60 SCHOOL ST (413)387-7381 7PJUB-4N82783-2-21 HATFIELD, MA 01038 ISSUED ON: 04/10/2023 TO PERFORM THE FOLLOWING WORK: INTERIOR RENO 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: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: l` Fees Paid: $481.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner ets 1 L. F. � _F-4 r .,....7-,_ , .._ � f 1 _„. The Commonwealth of Massachusetts ; FOR Board of Building Regulations and Standards ApR , MUNICIPALITY Massachusetts State Building Code, 780 CMR 2023 USE L. Building Permit Application To Construct,Repair„Renova olish a Rgcised ar 2011 "'One-or Two-Family Dwelling r4N,Dq ^��rn,p c ;fN This Section For Official Use Only =n�A 0,00 Building Permit Number:&P -1?-7•2-1 Date Applied: IV : II ` ) 1 j C. ", 9 ) oP3 g Buildin Official(Print Name) Signature i Date SECTION 1:SITE INFORMATION 1.1 Prop rty Address: , I 1.2 Assessors Map&Parcel Numbers r 73 11It55R4alC ST.I NOct..MrtW1pNNI IA I\ ).4l'. Oc 10 - bo 1.1 a Is this an accepted street?yes y 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 lid Private 0 Check Zone: _ Outsidesck if yes❑Flood Zone? Municipal tic On site disposal system 0 SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: F-AniLtIP fk*-1.14.0Itfi-tti+ 1p ro 0 1 IA A- o(0 (¢O Name(Print) City,State,ZIP lb VIAg6”o1x St. 112-6415 - (eoo2. lbw(clicAA1 S P fh„A,t ( . i,aw\ No.and Street Telephone Email Addres SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) IS Addition ❑ Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work': 1 t)tt.(t.t,fL t. °p VA, I N t:L.U 0 I 0 b 'Rk.A04 NJ )KUL5 l A lJ 4.v.) Wll rJ 1`SPLI C SiVt &, Vt 14LW 0 tt. L Arm illae'8403 lr SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 51 0 p 0 0 0 1. Building Permit Fee: $ Indicate how fee is determined: I 2.Electrical $ 10 D no 0 Standard City/Town Application Fee t . 0 Total Project Cost (Item 6)x multiplier _ x 3. Plumbing $ 21 p tD 0. 2. Other Fees: $ 4. Mechanical (HVAC) $ A ( 0 60." List: 5. Mechanical (Fire $ O al Suppression) Total All F (� Check Nd" Check Amount: '1 / ' Cash Amount: 6.Total Project Cost: $ 119 Q(� . 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) G5' .I0 °ll l 1 124 /Z -7 1 A,p&U1J License Number Expiration Date Name of CSL Holder S r• List CSL Type(see below) 0 No.and Street Type Description 1 I _ `n �� Unrestricted(Buildings up to 35,000 cu.ft.) O IrLD I l R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances d 0AeOtk womic 44 I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) i`1 (I b 2 2 A 114, iv L4(,�it (X114,'21 L.I,C HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name �nt OI.. 5r, molk. t,oitA No and Street Email address ol03's 4113 58"1-1Sb 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 1114tiAA S ' )1 '/ J.) to act on my behalf,in all matters relative to work authorized by this building permit application. V k' w tk U L Ac i, (,, 102.77 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. 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,fmished 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 Massachusetts DEPARTMENT OF BUILDING INSPECTIONS a �" 212 Main Street • Municipal Building ily.. a Northampton, MA 01060 �l+ny ot�J' 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: The debris will be transported by: Name of Hauler: W� '�( I� 44 5t l !AAA) MA ©103b Signature of Applicant:- ( - Date: 41(, 1u23 AC R CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 11/14/2022 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 Scott King,CIC NAME: [ratio King&Cushman Inc. PAHONI EA: (413)584-5610 ua tad}: (413)584-9322 P.O.Box 447 EMAIL sking©kingcushman.corn ADDRESS: 176 King Street INSURERS)AFFORDING COVERAGE NAIC N Northampton MA 01061 INSURER A: National Grange Mutual Insurance Co _ INSURED INSURER B: The Tucker Group LLC,DBA:Dadmun Design&Construction INSURER C: 60 School St INSURER D: INSURER E: Hatfield MA 01038 INSURER F: L. COVERAGES CERTIFICATE NUMBER: CL22111405023 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. WSW -ADDL SUBR POLICY EFF ` POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER ) (MMIDD/YYYY1 LIMITS MD WVD tMMIDD/YYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR PREMISES(Ea occurrence). $ 500,000 MED EXP(Any one person) $ 10,000 A MPT4694Q 11/13/2022 11/13/2023 PERSONAL&ADVINJURY $ 1,000,000 GEN'LAGGREGATELIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY EC LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER FITRV $ 5,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED - SCHEDULED BODILY INJURY(Per accident) S *....__.,. AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY IY).MAGE $ AUTOS ONLY AUTOS ONLY (Per accident) $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION I STATUTE I I ERN AND EMPLOYERS'LIABIUTY Y!N ANY PROPRIETORHPARTNE:FUEXECUTIVE E,L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? 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 I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) F 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 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Commonwealth of Massachusetts 11/3 Division of Professional Licensure Board of Buildmg Regulations and Standards C o ns ttitiett4ittlitUpw;:v sor ' CS-107919 Ø., frt!soines:09/24/2023 THOMAS DADMUN " '4fr:1 60 SCHOOL STREET X HATFIELD MA,01031 , /./ la 'so iv:, Commissioner jjeeqk '1e7449eigik. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: LLC � W :e nation: 179682 THE TUCKER GROUP LLC E. 6ation: 08/27/2024 D/B/A DADMUN DESIGN &CONSTRUCTION .» ""� A si 60 SCHOOL ST ' "" _ .. HATFIELD, MA 01038 l4 Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation Registration valid for individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: TYPE:LLC Office of Consumer Affairs and Business Regulation Registration Expiration 1000 Washington Street -Suite 710 179682 08/27/2024 Boston,MA 02118 THE TUCKER GROUP LLC. D/B/A DADMUN DESIGN&CONSTRUCTION THOMAS DADMUN ,f 60 SCHOOL ST +`x t/ HATFIELD,MA 01038 x ,_e `✓ IlkUndersecretary Not valid without signature The Commonwealth of Massachusetts 1 =*: /, Department of Industrial Accidents illm 1 Congress Street,Suite 100 mill_ Boston,MA 02114-2017 '�( www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information p Please Print Le�uibh Name (Business/Organization/Individual): Tl+ jU -_1L l.Lj '^(L.5.1)i �,..UC, Address: ( O S( ol- ST'. City/State/Zip: 14A 1- A-1 1 IAA 010 58 Phone#: 4l3- )b7-1 S6 t Are you an employer?Check the appropriate box: Type of project(required): 1.❑I am a employer with employees(full and/or part-time).* 7. ❑New construction 2 0 I am a sole proprietor or partnership and have no employees working for me in 8. ali Remodeling any capacity.[No workers'comp.insurance required.] 0 l am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. Demolition 10 0 Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5. I am a general contractor and I have hired the sub-contractors listed on the attached sheet.71 13. Roof repairs These sub-contractors have employees and have workers'comp.insurance.' 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14. Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: 1- (- `1-A)i,Li41; Policy#or Self-ins.Lic.#: P,L)I - 4 N 5 )-) t'lJ - L"Z 3 Expiration Date: lib l@ '2.4. Job Site Address: I'5 f l 1691151svLi i) '. City/State/Zip: 1 d11.11Od4‘-spi++ 1"t tk 01,0(10Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiral!ion date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi ,under the pain ndpenalties of perjury that the information provided above is true and correct. Signature: , 44`11 Date: 4((ol 2 2-127 Phone#: 4 [1 367 "790f9 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: DADMUN Design + Construction Protect Address: SubContractor List 73 Massasoit St 4/6/2023 Northampton, MA 01060 Subcontractor: Has Employees: Yes No Geryk Plumbing & Heating X Marney Electric X Alexander Leonardi X All Seasons Heating X Rightway Drywall X Executive Painting X Dion and Sons Flooring X A ORL CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD VYYV) 02/21/2023 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 Cyndie Henderson CISR,CPIA NAME: Alera Group,Inc. PHONE Exs): (413)586-0111 FAX No): (413)586-6481 (A/C,Webber&Grinnell Division E-MAIL chenderson@webberandgrinnell.com ADDRESS: 8 North King Street INSURER(S)AFFORDING COVERAGE NAIC# Northampton MA 01060 INSURER A: Merchants Mutual INSURED INSURER B: Merchants Preferred Marney Electrical Services,Inc. INSURER C: Associated Employers Insurance 11104 Attn: Jeff Marney INSURER D: 175 Main Street INSURER E: Leeds MA 01053 INSURER F: COVERAGES CERTIFICATE NUMBER: Master Exp 07/2023 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 NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD (MM/DD/YYYY) (MM/DD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 �/ DAMAGE 1 O RENT ED 500,000 CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 15,000 A BOP1106336 01/01/2023 01/01/2024 PERSONAL&ADV INJURY $ Included GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JECT PRO LOC PRODUCTS-COMP/OPAGG $ 2J00 0,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ B OWNED v SCHEDULED MCA1002862 01/01/2023 01/01/2024 BODILY INJURY(Per accident) $ AUTOS ONLY /. AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ X AUTOS ONLY X AUTOS ONLY (Per accident) -_ Uninsured motorist BI $ 20,000 X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 2,000,000 A EXCESS LIAB CLAIMS-MADECUP9150811 01/01/2023 01/01/2024 AGGREGATE $ 2,000,000 DED X RETENTION$ 10,000 $ - WORKERS COMPENSATION AND EMPLOYERS'LIABILITY X STATUTE X EORH Y/N 500,000 C ANYCER/MEETOR/PARTNER/EXECUTIVE N N/A WCC50050225412022 07/01/2022 07/01/2023 E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I 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 DADMUN Design+Construction ACCORDANCE WITH THE POLICY PROVISIONS. 60 School Street AUTHORIZED REPRESENTATIVE Hatfield MA 01038 i t.-- r p--�i I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ® DATE(MMIDD/YYYY) A�O CERTIFICATE OF LIABILITY INSURANCE 05/24/2021 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 Cyndie Henderson CISR,CPIA NAME: Webber&Grinnell PHONE 586-0111 (413)586-6481 (A/ o,Ext): FAX No): 8 North King Street E-MAIL : chenderson@webberandgrinnell.com INSURER(S)AFFORDING COVERAGE NAIC# Northampton MA 01060 INSURERA: Citizens Ins America/Hanover 31534 INSURED INSURER B: Allmerica Financial Benefit/Han 41840 John T.Geryk Plumbing&Heating,LLC INSURER C: Massachusetts Bay Ins/Hanover 22306 - 89 Oak Street INSURER D: INSURER E: Florence MA 01062 INSURER F: COVERAGES CERTIFICATE NUMBER: Master Exp 11/2021 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 SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD (MMIDD/YYYY) (MM/DD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 100,000 MED EXP(Any one person) $ 10,000 A ZBNH092909 11/15/2020 11/15/2021 PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY JECT PRO LOC PRODUCTS-COMP/OPAGG $ 4,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ B OWNED 'se SCHEDULED AWNH9175601 11/15/2020 11/15/2021 BODILY INJURY(Per accident) $ _ AUTOS ONLY /—, AUTOS HIRED ..,/ NON-OWNED PROPERTY DAMAGE $ X AUTOS ONLY AUTOS ONLY (Per accident) Underinsured motorist BI $ 100,000 UMBRELLA LIAB .C _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY X STATUTE X ERH Y/N 500000 C ANY PROPRIETOR/PARTNER/EXECUTIVE N N/A WDNH09187001 03/12/2021 03/12/2022 E.L.EACH ACCIDENT $ , OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I 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 Dadmun Design&Construction ACCORDANCE WITH THE POLICY PROVISIONS. 60 School Street AUTHORIZED REPRESENTATIVE Hatfield MA 01038 I,,t_—3 c�-�--'4' 1 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD