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25A-149 (4)
BP-2023-0859 52 WOODBINE AVE COMMONWEALTH OF M SSACHUSETTS Map:Block:Lot: 25A-149-001 CITY OF NORTHA PTON Permit: Agricultural All Bldgs PERSONS CONTRACTING WITH UNREGI TERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARA TY FUND (MGL c.142A) BUILDING PERMIT Permit # BP-2023-0859 PERMISSIO IS HEREBY GRANTED TO: Project# 2023 RENO Contractor: License: Est. Cost: 80000 SEAN MCCARVEL 117811 Const.Class: Exp.Date: 02/28/202 Use Group: Owner: KATH EEN YARROWS Lot Size (sq.ft.) Zoning: URB Applicant: SEAN CCARVEL Applicant Address Phone: Insurance: 170 WEST ST (413)406-6678 SOLE PROPRIETOR NORTHAMPTON, MA 01060 ISSUED ON: 07/03/2023 TO PERFORM THE FOLLOWING WORK: KITCHEN AND BATH RENO AND OTHER INTERIOR RENOVATIONS 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 MAYBE REVOKED BY THE CITY OF NOR HAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: . 51.41 Fees Paid: S560.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissi ner -7r p t&, . uyheh_ ` �C`c ti :1/ U � The Commonwealth of Mass u�. Office of Public Safety and Inspections 9Tti U��bIN Massachusetts State Building Code(780 CMR) MprO4�'SpF cr Building Permit Application for any Building other than a One-or Two-Fa ' g (This Section For Official Use Only) Building Permit Number:023. I 0 Date Applied: Building Official: SECTION 1:LOCATION cl / 5315Y 11erMt4mphn V I D6o Nottnt I✓( ,...LC_ ity/Town Zip Code Name of Building(if applicable) Assessors Map# Block#and/or Lot # SECTION 2:PROPOSED WORK Edition of MA State Code used qfh If New Construction check here 0 or check all that apply in the two rows below Existing Building fl Repair Alteration 0 Addition 0 Demolition 0 (Please fill out and submit Appendix 2) Change of Use 0 Change of Occupancy 0 Other 0 Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes 0 No Fj Is an Independent Structural Engineering Peer Review required? Yes 0 No fez Brief Description of Proposed Work: 4-0" +n 4- n (e , ` nc loot dr,Q,n dmv :h Kn • 2,(c , SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATTON,ADDITION,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑ Existing Use Group(s): a2. Proposed Use Group(s): $ 2.. SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft) y 1 /S1' y` 2 ' /54/2 Total Area(sq.ft.)and Total Height(ft.) 6t` 3 y' 6/6c6 3 e/' SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1 0 A-2 0 Nightclub 0 A-3 0 A-4 0 A-5 0 B: Business 0 E: Educational 0 F: Factory F-1 0 F2 0 H: High Hazard H-1 0 H-2 0 H-3 0 H-4 0 H-5 0 I: Institutional I-1 0 I-2❑ I-3 0 I-4 0 M: Mercantile 0 R: Residential R-10 R-2¢, R-3 0 R-4 0 S: Storage S-1 0 S-2 0 U: Utility 0 Special Use 0 and please describe below: Special Use Description: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA El IB ❑ IIA ❑ IIB 0 IIIA ❑ IIIB ❑ IV 0 VA 0 VBeit SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item) Trench Permit Debris Removal: Water Supply: Flood Zone Information: Sewage Disposal: Licensed Disposal Site El Public(El Check if outside Flood Zone IN Indicate municipal IXtrench will not be P Private 0 or indentify Zone: or on site system 0 r quired j®or trench or specify: plermit is enclosed 0 Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process: Not Applicable g Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed 0 Yes 0 or No IF Yes 0 No 0 SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: 9 tit (Mho Use Group(s): It k Type of Construction: v8 Does the building contain an Sprinkler System?: 10 0 Special Stipulations:_ Design Occupant Load per Floor and Assembly space: City of Northampton Massachusetts 1 ' # DEPARTMENT OF BUILDING INSPECTIONS �' W 212 Main Street • Municipal Building .�rf Northampton, MA 01060 t'! PROCEDURE FOR OBTAINING A BUILDING PERMIT FOR COMMERCIAL & MULTI-FAMILY NEW CONSTRUCTION/ADDITIONS/ALTERATIONS 1. Building Permit Application signed by legal owner and filled out by owner or authorized agent. 2. One set of plans and,specifications of proposed work (Digital & Hard copy). 3. Site Plan with location of proposed structure(s) and setbacks. ,4. Construction Debris Affidavit filled'out and signed b' applicant. 5. Worker's Compensation Insurance Affidavit filled out and signed by applicant. 6. Contractors must supply a copy of CSL and proof of Liability Insurance. 7. Energy Conservation Compliance Certificate (if applicable). 8. Note any Conservation and/or Special Permit requirements (if applicable). 9. Driveway Permit (if applicable). 10. Proof of Water and Sewer entry fees paid (if applicable). 11. Trench Permit (if applicable). 12. Initial Construction Control Documents filled out and signed by the Registered Design Professional in responsible charge. 13. Please provide the appropriate fee in the form of a check made payable to: The City of Northampton / \ J SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner 5 V C ?roper fl e5 I I Go 1 u4't Gas kit Nor i'li ai►p ton M+ °(CIO Name(Print) No.and Street City/Town Zip Property Owner Contact Information: Ma,,g9er (0oe9 ro th; 587- qq S YY b get 5-.6Noh d C 5'Q >'altoo.ton Title Telephone No.(business) Telephone No. (cell) e-mail a dr ss If applicable,the property owner hereby authorizes: 0c914c 67 wgi fitl,erf /7 cm►Iiti btis Nork4 tMfsh � 12lar 0/06 -Name Street Address City/To n State Zip to apply for and act on the property owner's behalf,in all matters relative to work authorized by this building permit application. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 1) If a building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here Tit. . Otherwise provide construction control forms(see section 107 in the code)as required. 10.1 Registered Professional Responsible for Construction Control(the professional coordinating document submittals) Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contractor 1;rl evte111 Uet34 bet-h sij 8 it; I4er Company Name SGQ,4 `CA rat'I C.3 •-1I 7511 (tnrest r;atl Lon(31'etc/lit h Sq,Prl'k.'gia Name of Person Responsible for Construction License No. and Type if Applicable 110 v) est 51- IVord-h aslavn "I A ©t,6o Street Address City/To n State Zip ' Y1z-fir 4675 16- ` o6- 667€6 Seni & nog I/l3 • Cool Telephone No.(business) Telephone No.(cell) e-mail address SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§25C(6)) A Workers'Compensation Insurance Affidavit from the MA Department of Ind strial Accidents must be completed and submitted with this application. Failure to provide this affidavit will result in the d nial of the issuance of the building permit. Is a signed Affidavit submitted with this application? Yes CI No C SECTION 12:CONSTRUCTION COSTS AND P1RMIT FEE Item Estimated Costs:(Labor c1 C) 000 and Materials) Total Constructionpost(from Item 6)=$ V / 1.Building $ C 6-dC)0 Building Permit Fee=Total Construction Cost x • ere 2.Electrical $ appropria municipal factor)=$ • .560 3.Plumbing $ , ,--' a QQ 4.Mechanical (HVAC) $ Note:Minimum ee=$ (contact municipality) 5.Mechanical (Other) $ Enclose check payabl to C.i Oil- g Drilllam 6.Total Cost $ U 0 000 (contact municipality) d write chhck number here A SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT 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. Please print and sign name Title Telephone No. Date Street Address City/Town State ip Email Address Municipal Inspector to fill out this section upon application approval: /�� 7.3.70•Z3 Name Date CITY OF NORTHAMPTON • SETBACK PLAN MAP. ,,r LOT: • LOT SIZE: 'REAR LOT DIMENSION: • • REAR YARD_ • • • SIDE YARD 7 • SIDE YARD • FRONT SETBACK FRONTAGE City of Northampton ri1 err Massachusetts DEPARTMENT OF BUILDING INSPECTIONS r �+ 212 Main Street • Municipal Building Northampton, MA 01060 'S' k", Pi " 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: VC! ( (Cy u�l QC�.L�idlO� The debris will be transported by: Name of Hauler: 11' 13 D p 5i-er. cod''1 Signature of Applicant: i �i Date: g pp /:-.2,17/23 4 The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 Boston, MA 02114-2017 www.ntass.gooldia It takers' (Ompensation Insurance Affidavit:Buiklersl'ontractorsiElectricians.'Plumbers. 10 HI:FILED WITH THE PERAli F I I (;AtirtioRin. Applicaiit Information Please Print l_rgibl% Name IHIISITheS'Organiznn I n,d.‘ dua , Friel/j 14111% Lot' itet d et: e.r ($Eqn Ilk 4 ierke0 Address: 1 70 Wes s4- City/State/Zip: Itleril-lictiripio A 4 oltio Phone P: /3 7$' Are you WI employer?l'ileck the oppenprisie but: T.:4pe of project lrequired): am a employa uati employees(full and*part-tirnel.• 7. Ej New construction 2 *4 am a sok pramrsetur or partnership and have no employras working for ow 11/ 8_ SI Remodeling 4' any capacity.No st"niers coup.MN UrafICI: trtmarett.i 9_ CD Demolition I am a honk."no-doing all work myself.1140 wooliers'comp assurance required_ 10 0 Building addition 4.0 I am a homeowner and A III bo kin mg t...on.trociaft to l'Orikluct all work 013 my prockrty. I will ensure that all(Andra:MN cirk* workers'conmenuatton nuuranix or are sole LC)Electrical repairs or additions proprietors with noemployets. r 5 I 2. 4 Plumbing repairs or additions _ . .50/1 am a gaserai tinalmi:Eut anti I have hued tbe sob-contraction listed on tlx anached%heel S I 0 -7 Ththe xibi.-outrziaors hove onployees and hat r workers'comp.insurarice, I 3.1-11ZO4Jf repairs pt4mber We ore a corporation and:I,officers have exercised then right or exemption Nr fd161. 14.00thei 152.§114i, c lute no employees.1'4o workers'comp.insurance required 'Any applicant that ehtvits hot al min:also till out the teetion below show inn their A utters'conmensation polity ink:motion t tkqueowners who sancta that atTalasit indating they orations':all work and then hoe tmtside...trots-actors must submit a new affoLa"it owliu2m such, %Cunt/al:tura that checit thrs box must attached an adthutinal sheet show inw the nun ul the subraontractors and.14a6c v.hotter or not ilk 1,14:+CUM eN 11_1%e anpl It the 11..cuntractursI loyees,they noisy pny.Kb:their worktms'c.mip,policy numbcr, I am an employer that is providing workers'compensation insurance fur my employees. Below 18 the policy and job sire information. Insurance Company Name. Policy#or Self-ins.Lk. Expiration Date: Job Site Address. i'.41j 5 A — if Wood b Citv-State,'Zip: A),y411 414 4P1 itti4,6 Attach a copy of the rs'compensation polky declaration page(showing the policy number and ration date). Failure to secure coverage as required under MGL c. 152.§2.5A is a criminal violation punishable by a tine up to SI.500b0 mot or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a tine of up to S250.00 a day against the violate A copy'Atli!, ,,.atement may he forwarded to the°Moe of Investigationsof the DIA for insurance r.t veritic.ttion I do hereby cert'y under the pains and pen altlec o fhiPIhi information provided above is true and correct Signature: Phone 9/3 Officiat ust!ortij. Do not',rite in:hi et/TO.to he completed by city or town official City or Town: PermittLicense Issuing Authority(circle one): • Board of Health 2.Building Department 3.CityiTown Clerk 4.Ekctrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ..• Initial Construction Control Document 1 ./1 i i . _ , 14 To be submitted with the building permit application by a / 4, , Registered Design Professional e # for work per the ninth edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Date: Property Address: Project: Check(x)one or both as applicable: New construction Existing Construction Project description: I MA Registration Number: Expiration date: ,am registered design professional.and I have prepared or directly supervised the preparation Mall design plans,c mputations and specifications concerningl: Architectural Structural Mechanical Fire Protection Electrical thet for the above named project and that to the best of my know dge, information, and belief such plans, computations and specifications meet the applicable provisions of e Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed prof t_ I understand and agree that I (or my i designee)shall perform the necessary professional services and be plresent on the construction site on a regular and periodic basis to: I 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirernients of the construction documents. 2. Perform the duties for registered design professionals in 780 1CMR Chapter 17,as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107_ When required by the building official,I shall submit field/progress reports(see item 3 )together with pertinent comments,in a form acceptable to the building official. Upon completion of the work,I shall submit to the building official a'Final Construction Control Document'. Enter in the space to the right a"wet" or electronic signature and seal: Phone number: Email: --- 1374iMing Official Use Only Building Official Name: Permit No.: Date: ., . . .,,,, .. , ......_ ..„. Note 1.Indicate with an'se project desit,plans,computations and specifications that you prepared or directly supernsed If'other is chosen,provide a ciesaiption. Version 0 1_01_2)31 Appendix 1 Construction Documents are required for structures that must comply with 780 CMR 107. The checklist below is•a compilation of the documents that may be required. The applicant shall fill out the checklist and provide the contact information of the registered professionals responsible for the documents. This appendix is to be submitted with the building permit application. Checklist for Construction Documents* Mark"x"where applicable No. Item Submitted Incomplete Not Required 1 Architectural 2 Foundation 3 Structural 4 Fire Suppression 5 Fire Alarm(may require repeaters) 6 HVAC 7 Electrical 8 Plumbing(include local connections) 9 Gas(Natural,Propane,Medical or other) _ 10 Surveyed Site Plan(Utilities,Wetland,etc.) 11 Specifications 12 Structural Peer Review 13 Structural Tests&Inspections Program 14 Fire Protection Narrative Report 15 Existing Building Survey/Investigation 16 Energy Conservation Report 17 Architectural Access Review(521 CMR) 18 Workers Compensation Insurance 19 Hazardous Material Mitigation Documentation 20 Other(Specify) 21 Other(Specify) 22 Other(Specify) *Areas of Design or Construction for which plans are not complete at the time of application submittal must be identified herein.Work so identified must not be commenced until this application has been amended and the proposed construction document amendment has been approved by the authority having jurisdiction. Registered Professional Contact Information Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date - Name(Registrant) Telephone No. ♦e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date Please follow this link for construction control forms to be used by Registered Design Professionals. j 1 . 1 n 1 l I I i 1 I_!3 NE . • • • i i 1 , --. • . , .I • . f 1. , . • I i , • I- t 1 ' I ' 1 I t i ; I , j I .0I t I i t I i I i I_ S I j 1 1 , I . I I , j i - i -- I I ; I ; j• II j 4 I I I.I 1 I• . J. 3• ; , , I , to i L il . 1 I 1 � i , I : , I �: • • I- . o .!. I .r i , . 1 . 7 60. -7 7 C!' ��_, U' s r -- i 1 7 • 1 1 ,I � 1 () Il -V---=-A -- - tTa ._... . ,i ____.__.- _ - � ___.1 __-.____ _ .. .�._ i "`_ ._. . Cr . � _ / • I , . I . }. • 7---- ." -' 'T. 1 1— 1-- , . y.,, f • , , , , , , • , , I � l — , , , , ,. , _ .__ . _— :— t —. ^±— _.. /'.per- �_ -�. , i • - -- — .� I _ - - EIE ' I. i I 1 j, ! i T _ _ I i . _ _ I. j I , e. , , , , • _ . . -. , . , 6,, , . , I • . . • , • , •,,,,, . , , 1 h�, , .r..... , , ,• • ,.,,.. ._,_T........,..._____............, ,_ , , . ...., ,______ , • _, 1 I I • i j I' — , i I t i i 7 I I f • — 1 I I I I j , • I 1 ; 1 � v ij • j , { Lt , 1 I i •6f,7 - I • i I I —E.- --1--,...E.-1-1.--- -, ' .4.--....-:, --- --- --- -re.m.— ' - _ . \— I t _ — — l { } I_ _ — —_ _ _c — — — I I I ? • i i R I 1 i i J I - :- —; =c _ __(:) — — I _ ' psi 1.--�' l i f G ± H? ¢ i % . ' i 1 T—! 1 141 Aid/bunted paigiKturiziL 6 -A3- S51 From: �ea,n i e-Ca ri4 ( (Fctenj (r Wetft lour kod 43,4;Aler 11 (70 t,'ecI- 5 — or1-11avt e4 MA-,0(060 To: Jonathan Flagg • Building Commissioner City of Northampton 212 Main Street Northampton, MA 01060 The Massachusetts Building Code, section 107.1 allows for an exclusion from requirements for construction control in certain situations. In accordance with code section 104.10, I request that you grant a modification to waive the requirement for construction control of the project at St( W&©d b:Ae koe (V or I-hairy/ i/ M l6 b because the work is of a minor nature, will not affect structural elements, health, accessibility, life or fire safety, and will be done in accordance with the prescriptive requirements of the code. Thank you for your consideration. Respectfully, Construction Supervisor Commonwealth of Massachusetts Unrestricted -Buildings of any use group which contain Division of Occupational Licensure less than 35,000 cubic feet(991 cubic meters) of enclosed Board of Building Req ulations and Standards space. Const too, re rvisor F 3-117811 - 6‘pires: 02/28/2026 c !_ SEAN M MCt ARVEL '1- 170 WEST STREET NORTHAMPTON MA 01060 / 0At Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. /� For information about this license Commissioner ClaA i . D L Call (617)727-3200 or visit www.mass.gov/dpl • /l,Llie'*J- Office of Consumer Affairs and Business Regulation 1000 Washington Street- Suite 710 Boston, Massachusetts 02' 18 Home improvement Contractor Registration Type: Individual SEAN MCCARVELRegistration: 196403 D.!B/A FRIENDLY NEIGHBORHOOD BUILDER Expiration: 08!11/2023 170 WEST ST NORTHAMPTON. MA 01060 Update Address and Return Card. • G 20M-0517 Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for ind vidual use only TYPE:Ind v dual before the expiration date. If found return to: Registration Expiration Office of ConsumerAffai•s and Business Regulation 196403 08/11/2023 1000 Washington Street -Suite 710 SEAN MCCARVEL Boston,MA 02118 (MA FRIENDLY NEIGHBORHOOD BUILDER SEAN MCCARVEL 170 WEST ST .w, :%. :>:!f, - NORTHAMPTON,MA 01060 Undersecretary Not valid without signature Construction Supervisor Unrestricted -Buildings of any use group which contain less than 35,000 cubic feet(991 cubic meters)of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For information about this license Call (617)727-3200 or visit www.mass.govldpl ACRD® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/OD/YYYY) 03/03/2023 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 Lilliam Martinez,CISR,CPIA NAME: King&Cushman Inc. PHONE (413)584-5610 FAX (413)584-9322 A/C,No,Ext): (A/C,No): P.O.Box 447 E-MAIL LMartinez@KingCushman.com ADDRESS: 176 King Street INSURER(S)AFFORDING COVERAGE NAIC# Northampton MA 01061 INSURER A: Green Mountain Insurance Company 20680 I INSURED INSURER B Sean McCarvel INSURER C: 170 West St INSURER D: INSURER E: Northampton MA 01060-3739 INSURER F: COVERAGES CERTIFICATE NUMBER: CL233305219 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 (MM/DD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO NTED CLAIMS-MADE X OCCUR PREMISES(EaEoccurrence) $ MED EXP(Any one person) $ 5,000 A 20031304 08/14/2022 08/14/2023 PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) • UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ,. ANY PROPRIETOR/PARTNER/EXECUTIVE N/A El.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ It 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) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Northampton ACCORDANCE WITH THE POLICY PROVISIONS. 210 Main St AUTHORIZED REPRESENTATIVE Northampton MA 01060 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered mairks of ACORD