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23A-009 (3) BP-i023-0458 36 PARK ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 23A-009-001 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-2023-0458 PERMISSION IS HEREBY GRANTED TO: Project# 2023 SHOWER Contractor: License: Est. Cost: 15000 LONG ROOFING OF MASS LLC 115540 Const.Class: Exp.Date: 12/29/2024 Use Group: Owner: A GILBOY JOSEPH T& KATHLEEN Lot Size (sq.ft.) Zoning: URB Applicant: LONG ROOFING OF MASS LLC Applicant Address Phone: Insurance: 24 WALPOLE PARK S UNIT 8 (240)473-1400 WC5-3 1 5-626 1 42-01 3 WALPOLE, MA 02081 ISSUED ON: 04/14/2023 TO PERFORM THE FOLLOWING WORK: BATH RENOVATION 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: 9si le [� yCl • Fees Paid: $97.50 212 Main Street,Phone(413)587-1240,Fax: (41 3)587-1272 Office of the Building Commissioner Aie.'--- !r I- - r_ The Commonwealth of Massachusetts% I • Board of Building Regulations and Stand trds FOR Massachusetts State Building Code, 780 CMR' RPA 7 4 MUNI PALITY SE i Building Permit Application To Construct,Repair,Rery°vatpfrp T emolish a 7tevise Mar1:2011 One-or Two-Family Dwelling I n,rurtniti �' .,THAMhr C 1lyFECT! - I This S ction For Official Use Only orv�Q`o ws Buildin Permit Number: ,(jjlo- A 3- 115x Date Applied: _,� i duty /Zr55 11-N Z Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION l kyertyOdn s�nni w 1.2 Assessors Map&Parcel Numbers cc 1.1a Is this an accpted 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 ❑ Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Zec ord: 4: 0.0--VII"\LQ.0 Aik. Gt,(Di6y Rifisiines_ "It 0 iok2,g_ Name -ri t City,State,ZIP ` _ W3�3- b-O( 7 Irli2(60,p33 Kei O ,/o.and Street Telephone ail Adss SECTION 3:DESCRIPTIO OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building Owner-Occupied 0 Repairs(s) ❑ Alteration(s) Addition El Demolition 0 Accessory Bldg. ❑ Number of Units Other Q Specify: Bri f De cription of Proposed Work2: ' /12 0 e . Lt) 7-4-rz.riv Cu ificee SECTI Iltk 4:ESTIMMEDD COSST CTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ Ifi 560 1. Building Permit Fee: $ _Indicate how fee is determined: 0 Standard City/Town Application Fee 2.Electrical $ / 0 Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ Lii lit; 2. Other Fees: $ 4.Mechanical (HVAC) $ List: i 5. Mechanical (Fire $ Suppression) Total All Fees: /'i �/ /�" Check No17(gv Check Amount: /'Cash Amount: 6.Total Project Cost: $ 1 V bba ❑Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) I SKI`r -Jr�� rn 1r'J1m�Q �� License umber '( U Expiration Date ,1/' -- Name of CSL Holder (� eMI List CSL Type(see below) No.and 0 Type Description /1 n 6a 74 U Unrestricted(Buildings up to 35,000 Cu.ft.) City/Town, a l��/�Y R Restricted 1&2 Family Dwelling M Masonry RC Roofing Covering WS Window and Siding ems � SF Sol d Fuel Burning Appliances it neigkc I Ins lation e ephone mail address .� D De olition 5.2 egistered Ho Improvement Contractor IC) 6JRegistration�� �rJ� Number E oration tc HI ompany r HI R ' trant arc -C � -� 1 .017 (M i •- 1 (n p . N n treet mail address 334-33-(,lce City/Town,valet S e,htZIP�� �� Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.§ 25C(6)) Workers Compensation Insurance affidavit must be mpleted and submitted with this application. Failure to provide) this affidavit will result in the denial of the Issuan 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 to act on my behalf,in all matters relative to work authorized by this building permit application. Print Owner's Name(Electronic Signature) 0-�Oct /�, -734— SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attes :er the pains . • • . tes of perjury that all of the information contained •in , is ap• • . • - a ac . - : - •est of my knowledge and understanding. q(?(03 Print - 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" 0 Tue 12.13 26224:42 PM Joyce Miller <jo fce.miller@khpp.us: RE: Request for Window Manufacturer's Specification Sheet Pires 652180 Tc Daniel Carlson Cc Customer Service;Anthony Yodice Meridian Double Hung U- glass Air CPD# factor SHGC VT Condensation Resistance Grid package Infiltration North KHI-M-23-00060-00001 0,2 0.23 0.41 65 G Barrier 0.08 cfm/ft= Meridian Slider North KHI-M-21-00060-00001 0.21 0.23 0.41 64 G Barrier 0.05 cfm/ft' Certified Products Directory(nfrc.org) Data can be verified at the link above using the CPD number. Joyce A. Miller Manager Customer Relations KHPP Windows and Doors 724-236-0503- Direct 724-845-5421 Fax MA HIC#187510 Page 6 of 22 Long Roofing, LLC • 16 International Drive Windsor, CT4 tq-; 0 06095 (800)470-LONG • (240)473-1400 • LongRoofing.com PRODUCTS By Long Roofing, LLC Joe Gilboy 4133200187 Date: 03/24/2023 Kathleen Gilboy gilboy133@gmail.com Product Specialist:Alden Ciquera 36 Park Street License Number: FLORENCE MA 01062 The Buyer(s) listed above hereby jointly and severally agree to purchase the goods and/or services listed herein, in accordance with the prices and terms described in this "Agreement." Homeowner's Association Approval Required NO I do not belong to an HOA. I accept FULL responsibility for this project and authorize installation I confirm that the above information is accurate / Dumpster Required NO I confirm that the above information is accurate /G Are there electric lines within 3 feet of where LHP will be performing work? NO Preferred Method of Contact Phone Phone/Text/Email 4133200187 Total Purchase Price $15,000 Deposit with Order $2,000 Amount Due on Substantial Completion $0 Amount Financed $13,000 Form of Deposit Check The Estimated Date of Commencement of the Work Is 8-12 Weeks The Estimated Completion Date Is 8-12 Weeks I am aware that the above dates are an ESTIMATE /G The Project Is Contingent Upon Obtaining Approved Financing THERE ARE NO ORAL AGREEMENTS /a Promotion Selected(Cannot be combined with other offers) Promotional Financing Customer Promotion Acknowledgment / This space intentionally left bank nclin 2.14.4 It is agreed and understood by and between the parties that this Agreement, constitutes the entire understanding bel7i of 22 the parties, and there are no verbal understandings, changing or modifying any of the terms of this Agreement. Buyer(s) hereby acknowledge that Buyer(s)has read Agreement and has received a completed, signed and dated copy of this Agreement, including the two accompanying Notice of Cancellation forms, on the date first written above. Buyer(s) acknowledge that they were orally informed of their right to cancel this transaction. /A4. acar Aiden Ciquera Joe Gilboy 03/24/2023 03/24/2023 Date Date Kathleen Gilboy 03/24/2023 Date You,the buyer, may cancel thistransaction at any time prior to midnight of the third business day after the date of this transaction.See the acconpanying notice of cancellation form for an explanation of this right. I ' I This space intentionally left blank I Page 2 of 22 MA HIC#187510 t _ <' : Long Roofing, LLC • 300 Myles Standish Blvd Taunton MA, 02780 $ ,r . (800) 470-LONG • (240)473-1400 • LongRoofing.com PRODUCTS By Long Roofing, LLC Joe Gilboy 4133200187 Date:03/24/2023 Kathleen Gilboy gilboy133@gmail.com Product Specialist:Aiden Ciquera 36 Park Street FLORENCE MA 01062 The Buyer(s) listed above hereby jointly and severally agree to purchase the goods and/or services listed herein, in accordance with the prices and terms described in this "Agreement." Windows Being Replaced: Partial Total Windows Being Replaced: 1 Entry Link Number N/A Window Job Specifications ✓ 1. Obtain all necessary insurance V 2.Arrange for pre-installation measure V 3. Prep individual work areas. (Homeowner is responsible to remove blinds, drapes, furniture, security systems and any special items.) V/ 4. Carefully extract existing window(s)/door(s) and prepare opening for new vinyl window(s)/door(s). ✓ 5. Install new vinyl window(s)/door(s) into existing opening. V/ 6. Square up/adjust new vinyl window(s)/door(s). ✓ 7. Insulate perimeter of window(s)/door(s)with fiberglass, if necessary. V 8. Custom wrap wood exterior with PVC coated aluminum coil stock. • 9. Caulk with OSI lifetime caulk. OSI can produce a strong odor that can last up to 10 days. ®/ 10. Clean up and remove old window(s)/door(s) and debris and dispose. • 11. WARRANTY- LIFETIME TRANSFERABLE WARRANTY Initials / Window Item 38-83 UI Window Style Double Hung Room Location Bathroom 1 Glass Package Low E Argon Size 28 x 38 Quantity 1 Capping Color Colonial White(PVC) White White Additional Details This space intentionally left blank Ieaptodigital.com 2.14.4 Image: 1.7 Page 5 of 6 T)'() (ii . ) Z--<Zi re-- ilIN *) 'fit/L/T-,./' • (_7; to lib Ift/Csli 6 ') 43 x IA 66 r Image: 1.8 , All `i )0( 1 4 cit vaP)--) TCail�"�� 1 G��' -o'- w [1, tvi iAci 28 x- ,2 7w,404/ 6-0 (soot io,,,,i tln(tal.rnm 2.14.4 City of Northampton ' Ir Massachusetts �w�.' '� , , i L_i "'r DEPARTMENT OF BUILDING INSPECTIONS �`, 212 Main Street • Municipal Building J�. b' Northampton, MA 01060 'flskh, 3,,0`^�C 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: 1)L\1/4U L- \\i- plt,vj ( 61 we -1\-DY\ --litxt- The debris will be transported by: Name of Hauler: _ ( Nkii_ ()NW-AC.1S-— Signature of Applicant: Date: CI THE COMMONWEALTH OF MASSAUHUSE I I S Office of Consumer Affairs ad Business Regulation 1000 Washingt6}4 TStreet,- Suite 710 Boston, M:assaehusett's 0,2118 Home Improveme fEetZ tractor-Registration i 11, 4vt I, .- - 1 x I 'S�j I ; 1� L,ggL iii' -~ lax;,, `Iv �; e: Supplement Card ` .� „ig �' I�Type: PP �tt+a •— Red�istitation: 187510 LONG ROOFING LLC ,,-A 41--_ L _ r Expiration: 04/20/2023 D/B/A LONG HOME PRODUCTS 'yi 'M1, fi - , ,7..r, - �' I � 8530 CORRIDOR RD, SUITE 200 -a , 'ti-- _ ' r IT ii,,Ma�'" SUITE 200 1, i.k 4 ,ii' SAVAGE, MD 20763 iw '+, . I `art ,1,` ' h. q _ 7 Y: �y '1 �"` Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS 6 Office of Consumer Affairs&Business Regulation Registration valid for individual use only before the HOME IMPROVEMEN CONTRACTOR i expiration date. If found return to: TYPrE S�rp.pPement_Grd Office Consumer Affairs and Business Regulation Registration Expiration 1000 a hington Street -Suite 710 1'187,110 04J2 0023 Bos on, A 02118 ONG ROOFING LLG� Ii—A 1i4. /B/A LONG HOME PRO,DU TS 1 ;r'i , TAMES COSTELLO 4;�s x"^aka y�4T � 1530 CORRIDOR RD,SUATE'235+ °�0 J . �„'`da'g Ormk / - / SA + ai l% SAVAGE, MD 20763 ` Undersecretary Not valid without signature . 3 • • • . . • • . . • •. . • 1 . 1 I . • • • • . • . . N,I..;•`.',.i.;:s.J• :‘,;....... ....A.;•3... 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'• . . . . . . • • - • . .. ' • . , . . 1 1 . . . •. . LINA The Commonwealth of Massachusetts 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 Legibly Name (Business/Organization/Individual): Long Home Products: Long Roofing LLC/Long Baths LLC Address:300 Myles Stanidsh Blvd City/State/Zip:Taunton MA 02780 Phone#:339-333-6118 Are you an employer? Check the appropriate box: Type of project(required): 1.0 I am a employer with 25 4. ❑ I am a general contractor alld I 6. New construction employees (full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ® Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addit on [No workers' comp. insurance comp.insurance.t required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs ! . insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other 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:Liberty Mutual Insurance Company Policy#or Self-ins. Lic. #:WC5-31 S-626143-013 Expiration Date:1/1/24 Job Site Address: 1, - Pea._ %alt.- City/State/Zip: r-741„, c Y" 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 i s and penalties of perjury that the information provided abo is true and correct. Si ature: Date: Phone#: 339-333- Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(check one): 10Board of Health 20 Building Department 30City/Town Cle 4.0 Electrical Inspector 5bPlumbing Inspector 6.0Other Phone#: ___,...--.4N LONGFEN-04 DHARRIS ACORif, CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) �� 1/3/2023 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 License#0C36861 CONTACT Danielle Harris NAME: Lanham-Alliant Ins Svc Inc PHONE FAX 16901 Melford Blvd Ste 123 (A/C,No,Ext): I(NC,No): Bowie,MD 20715 aiMDREss:danielle.harris@alliant.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Everest Indemnity Insurance Company 10851 INSURED INSURER B:Commerce Insurance Company 34754 Long Roofing LLC dba Long Home Products INSURER C:Burlington Insurance Company 23620 300 Myles Standish Boulvard INSURER D: Taunton,MA 02780 INSURER E: INSURER F: COVERAGES CERTIFICATE 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 PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TC ALL THE TERMS, I 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/YYYYI A X COMMERCIAL GENERAL LIABILITY 1,000,000 EACH OCCURRENCE $ CLAIMS-MADE X OCCUR CF4GL01198-221 12/31/2022 12/31/2023 pR M SES(EaEoccu ence) $ 100,000 MED EXP(Any one person) $ PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X JEC LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: EBL AGGREGATE $ 2,000,000 B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ _ANY AUTO BCDX02 12/31/2022 12/31/2023 BODILY INJURY(Per person) $ OWNED X SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) $ $ C UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 X EXCESS LIAB CLAIMS-MADE 600BE00525-03 12/31/2022 12/31/2023 AGGREGATE DED RETENTION$ Aggregate 5,000,000 WORKERS COMPENSATION PER AND EMPLOYERS'LIABILITY Y/N STATUTE EH R ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT S 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/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 i ACCORDANCE WITH THE POLICY PROVISIONS. Town of Florence, MA AUTHORIZED REPRESENTATIVE l7ffIle ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DATE(MM/DD/YYYY) ACORD CERTIFICATE OF LIABILITY INSURANCE 18/2023 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,MID 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, subjed 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 ALLIANT INSURANCE SERVICES INC NAME CT 16901 MELFORD BLVD STE 123 PHCNNo FAX,No1:_ BOWIE, MD 20715 a°1Mal.Ext) ADDRESS: SURER(S)AFFORDING COVERAGE NAIC# INSURER A: LM I urance Corporation 33600 INSURED INSURER B: LONG ROOFING LLC DBA LONG HOME PRODUCTS INSURERC: LONG BATHS LLC INSURERD: 8530 CORRIDOR RD INSURERE: SAVAGE MD 20763 - INSURER F: COVERAGES CERTIFICATE NUMBER: 72387605 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 SUCYPOLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR EXP L TYPE OF INSURANCE �gp jsy VD POLICY NUMBER (MM/DD Y (MCY EIFF M POLICY ) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES(Ea occurrence) $ MED EXP(My one person $ PERSONAL&ADV INJUR $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ • POLICY ECOT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED I BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MAI3E AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION WC5-31S-626143-013 1/1/023 1/1/2024 / PEATUTE ER OTH- AND EMPLOYERS'LIABILITY ANYPROPRIETORIPARTNERIEXECUTIVE Y E.L.EACH ACCIDENT $1000000 OFFICER/MEMBER EXCLUDED? IN (Mandatory in NH) E.L.DISEASE-EA EM LOYEE $1000000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1000000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) WORKERS COMPENSATION INSURANCE COVERAGE APPLIES ONLY TO THE WORKERS COMPENSATION LAWS OF THE STATE OF MA This certificate cancels and supersedes:alpreviously issued certificates,only as they relate to workers compensation coverage. 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. Town of Florece, MA AUTHORIZED REPRESENTATIVE •./�/ ,/ Jon Smith ©1988-2015 ACORD CORPORATION. All rights reservi ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 72387605 ) 1-626143 23-24 WC- ) n0270258:12/8/2023 5:11,08 PM (PST) Page 1 of 1