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24D-336-001 BP-2024-0087 133 FRANKLIN ST UNIT COMMONWEALTH OF MASSACHUSETTS A Map:Block:Lot: CITY OF NORTHAMPTON 24D-336-001 Permit: Exterior Res PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit # BP-2024-0087 PERMISSION IS HEREBY GRANTED TO: Project# 2024 ROOF Contractor: License: VASILIE KUKHARCHUK DBA Est. Cost: 12,500 MAJOR HOME IMPROVEMENTS CS-103054 Const.Class: Exp.Date: 08/24/2024 Use Group: Owner: MARADIK, JOHN T.&GLASER, RACHEL B. Lot Size(sq.ft.) VASILIE KUKHARCHUK DBA MAJOR HOME Zoning: URB Applicant: IMPROVEMENTS Applicant Address Phone: Insurance: 22 VERONA ST (781)913-6405 WC5-3 1 5-3 60 1 60 WESTFIELD, MA 01085 ISSUED ON: 01/29/2024 TO PERFORM THE FOLLOWING WORK: STRIP AND RE SHINGLE ROOF POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: 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: • • >9 Cgi 11 • I � Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner ,� The Commonwealth of Massachusetts Board of Building Regulations and Standards FOR I Massachusetts State Building Code, 780 CMR USE MUNICIPALITY Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number:P-202.4"002-7 Date Applied: 4,,,...,(055 i_Zq zee,/ Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property_Address: 1.2 Assessors Map& Parcel Numbers 4/j; /3 3A ,- l (12aD 336-bd t `� 1.1 a Is this an accepted street?yes 1/ no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: /Gz i f it (�' /I,333 ace 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: Publics Private 0 Zone: Outside Floodnf? Municipal 0--On site disposal system ❑ Check if yes❑ //et_ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Of6 ��- /h-C?JLC CLOP 0 �r Narhe(Print) City,State,ZIP /33A kr eui,LLA:(1l - ,Z6.2-a1.12-/cf3 '7 No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building El' Owner-Occupied Er Repairs(s) Er Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work': f7' <' ,(4,,.f I (-C./7 I • 31,Vcdf_ ii-e.c.0 OA abc (I a y te... 4 tvilli ri r SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ /42 e WO 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ ❑ Standard City/Town Application Fee ❑Total Project Costa(Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire Total All Fees: $ Suppression) $ 2" Di I ` l Check 03g16 Check Amount: Cash Amount: 6.Total Project Cost: $ A t W 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) ( _/6563Z/ v /q/jy 4"a71?/ 1 ��,�� ��L License Number Expiration Date Name of CSL Holder List CSL Type(see below) (/ V n� ��ibiLt Type Description No.o.and Street v U Unrestricted(Buildings up to 35,000 cu.ft.) faYr R Restricted 1&2 Family Dwelling City/Tow ,State,ZIP M Masonry RC Roofing Covering WS Window and Siding (1.4 SFSolid Fuel Burning Appliances �j l7 L� I Insulationone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) /)Ve f ( s3 //f orky veK f HIC Registration Number Expiration` Date HI p Name or HIC *straiitt N e /^�,A, ' A , ,' N S rc /WZC�Ya�-4J z •0( 3 36 gold Emai address City/Town, tate,ZIP elephone 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 7)/ ) J( (� kteLh a4C/Q.C1 to act on my behalf,in all matters relative to work authorized by this building permit application. thaA_Ccdt—t, ///c//,/ 134fit 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. / {471/if..t f ia'7£ /4°G` K Print Owner's or Authorized Agent's Name(Electronic Signature) Diate 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" ; mti ,..,i,`'` -, The Commonwealth of:Massachusetts y Department of Industrial Accidents --- 1 Congress Street,Suite 100 . Boston, :ill 02114-2017 u ; ,f www twass.gov/did 11 u»kers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information _ Please Print Legibly Name(13usinoss'Organ�tlouwIndividual)' `�4_-�0/ity,L71"(�/ � 5 i , Address: 2 ' 42 _J ,c.'J `/ JI J � /47( 6(0(1 City/State/Zip: Phone#: &j — —6 O y‘ ire yen so employer?Check the anprW.e bar: Type of project(required): 1.0 I am a employee with employees(full atnd'ot part-time).* 7. 0 New construction 2.0 I am a' ' proprietor or partnership and have no employees working tar ate in 11. 0 Remodeling say capaerty.[No workers'camp.insurance required.] 301 am a homeowner doing all work myself.[Nu wasters'comp_insurance required a 9. Demolition 1.0 I am a homeowner and will ba 10 Q Building addition hiring etorrraeeoes w eunduet all wnxA on my property_ I will Litman:that all ct, raG�attar have et+oetera'coei enaatrcm insurance or are.ok 11 a Electrical repairs or additions propnetors with no mMdoysaa. 5 I am a general contractor and I have hind the sub-contractors lilted on the attached sheet 12.. Plumbing repairs or additions 13 Thew sub-contractors haw employees and have worker'rump.i prance. 13 RI • r+f repairs 6.0 M'e are a eorporatiun and its officers have exercised their ngle of exemption per?JCL e. 14.0Otber 152.yv 1141,and we have no employees.[No warier.'coop.insurance rerequited"ed *Any applicant that cheeks box*1 mist also fill out the section below showing their wasters'aaatpaamettioa polity information_ 'Hum Iles u ho submit this atfu!•ac it indicatine,they are doing all+rock and then hire outside ooeatacton ratio submit a new affidavit indicating such. %Contractors that check this box aura attached an additional%beet show ing the name of the sob—avttrtaeton and state whetter or not those entities have employee, lithe sub-cuntractors have employees.they mist provide their .+ink cr.':%xnp.policy number 1 um an employer that 1s providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: lob Site Address: CityiStatefZip: Attach a copy of the workers'compensation policy declaration page(shoving the policy number and expiration'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 certify under the pains acid penalties of perjury that the information provided above is true and correct. Date: /" 'Li 7"/7 Sign 1 Phone#: it/3 J‘ 31 fcOf Official use only. Do nett write in this urea. to be t'ampleted by city or town official City or Towa: Permit/License# Issuing Authority(circle one): I. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector r,.Other ( tin tact Person: Phone#: City of Northampton Massachusetts C'i ��1 q C tt • ,. +11 DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building Northampton, MA 01060 44{ ;4.10Y 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: F -� C� The debris will be transported by: Name of Hauler: t J H //ff dii&C� -�C4 v U Signature of Applica�it Dater' oC Z 19 A CERTIFICATE OF LIABILITY INSURANCE DATE(UUJDD"YTY) 05/03/2023 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 pollcy(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 C°NTACT David R Jarry Neill&Neill Insurance Agency Inc 662 Riverdale Street wc.No.mot. 413-732.4137 I FAX 413-731-6629 West Springfield,MA 01089 ( No): EADDRESS: dj((gneillandneill.com INSURER(S)AFFORDING COVERAGE NAIC B INSURER A: Nautilus Insurance Company 17370 INSURED Milet,Inc. INSURERS: Liberty Mutual Insurance Company 23043 Major Home Improvements 22 Verona Street INSURER C: Westfield,MA 01085 INSURER D: 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 TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN SR TYPE OF INSURANCE AINDSD MD, POLICY NUMBER POLICY EFF POLICY EXP fYY/OD/YYYY) (MMIDDrYYYY) LIMITS A V COMMERCIAL GENERAL LIABILITY NN1534184 04/28/2023 04/28/2024 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR DAMAGE TO RENTED 100,000 PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JE T LOC O- PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY (IAMBINE&VINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY Peracddent $ - AUTOS ONLY _AUTOS ( ) HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY _AUTOS ONLY (Per accident) $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION WC5-31S-360160 06/09/2022 06/09/2023 V ISTATUTE ER AND EMPLOYERS'LIABILITY Y/N W C5-31 S-360160 06/09/2023 06/09/2024 ANY PROPRIETOR/PARTNER/EXECUTIVEE.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? , N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 i DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be atfschsd If more span I.required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE gl......and.„. . 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 1 Division of Occupational Licensure Board of Building Regulations and Standards ConsktitiVOn tS ervisor CS-103054 ,�L. ft,pires: 08/24/2024 VASILIE M K?KHARCHiYi(G' r 19 HUNTERS/SLOPE — WESTFIELD MA 010810 , ?Pt._ Wit' O ' ir.LVaN3- Commissioner dialOa K. Ekm to THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Aff.,47 .� Business Regulation 1000 Washing:'"Y:�?+- -Suite 710 Bosto - - —i 118 Home Im•ro."— -_= .iis�stration ' ----- —=-----.--1----- __r Type: Individual VASILIE KUKHARCHUK 1 e.-.ation: 150841 D/B/A MAJOR HOME IMPROVEMENTS !� E =lion: 05/03/2024 19 HUNTERS SLOPE WESTFIELD,MA 01085 ` __l=� Ey NIP Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer A 8 Business Regulation Registration valid for Individual use only before the HOME IMPRO NrRACTOR expiration date. If found return to: Office of Consumer Affairs and Business Regulation 1000 Washington Street-Suite 710 . `-'-. .--Y1: Boston,MA 02118 VASILIE KUKHARCH G'=.;./ D/B/A MAJOR HOM-It _ irt o VASILIE KUKHARCHU' .0-` _ _---__.� 19 HUNTERS SLOPE _ �oG. .d-'(f,,, WESTFIELD,MA 01085 =- „,' ram Undersecretary Not valid without signature STATE OF CONNECTICUT DEP I RT.NE.\T OF(VAS(.IJER PROTECTIO.S HOME IMPROVEMENT CONTRACTOR VASILIE KUKHARCHUK 22 Verona St Westfield,MA 01085 MAJOR HOME IMPROVEMENTS Registration# Effective Expiration HIC.0611632 04/01/2023 03/31/2024 SIGNED Date 12-4-2023 Joba Customer Name MAJOR HOPE IMPROVEMENTS John Maradik MAJOR HOME 22 Verona St.Westfield,MA 01085 CunbrneeS tit a Customers Work PAaie Office:(413)636 6046 �streA / 39 IMPROVEMENTS 133-A Franklin St. Roofing Caraior Canso/Rapttakehunter Cry State alp Code Agreement Page 1 Northampton MA 01060 isk� nor , hcrytnnz — 103054 g Mslation Address County dyes ❑NoCT UC Meg Address(II different from above) I Gin r state ry Cor""" w"4"Steve Bradbury Description of the Protect and Description of the SlonMcant Metereln ,J j lied sM q come nt to be h111Yd The wok m be done under los contract includes the bee. ng(where checked)' vermits,dumpster and dump fees are included in this contract Not Incitli d IBridfld S 9 Z S 00 Ettuatalta 1. .00r 0 Tear oil existbg roof shingles dawn to wood deck on entire houserese�Ylrif�as ISSA 2. 0 oilP Inspect wood deck and replace any rotten wood found in the deck area at a rats off 1$ 1F2"$$3 b 0 3/4"Per 4x8 foot sheet PLEASE NOTE:this amount is not included incite TOTAL PRICE shown below. $20.00 Per linear foot Customer end MHI agree that the TOTAL PRICE will be amended via a Contract Charge Authorization form b.add tie oasts of replacing rotten wood In the deck area discovered after existing roofing Merl*we removed t Customer(s)India!' intaiatign 3. .060 ❑ Furnish and install Ent nor Shingle: TYPE: Certainteed Landmark-GOOD COLOR: 4. A. 0 Furnish and Instal Synthetic Paper 5. p1" 0 Furnish and instal ice-damming eave protector 6'at eaves,3'at rakes-valleys-chimney-sirtijlde 6. ❑ Furnish and install starter shingle cn al eaves. 7. ea. 0 Furnish and nstaulreplace any deteriorated'L'lashing. p 'Wal .S Chimney .b Dormer 8. iiP 0 Furnish and instal metal drip edge along rake edges and eaves. is Whine 0 Brown 9. ❑ A' Furnish and instal skylight systems. 10. .arm 0 Furnish and instal new vent rovers on all vent pipes. 11. .411. 0 Furnish and instal attic ventilation system(Check all applicable). . hngle-over ridge vents 0 Soffit vents 12 0 jile. Furnish rubber roof 13. Cl d Finish and instal new flat roof Exterior Protection System: COLOR: ❑Ddp Edge 0 Tie-in under shingles ❑SA base sheet ❑a43 base sheet ❑SA cap sheet iikam 14. Cl rer Furnish and install guttering: COLOR: 15. ❑ ? Disposed old(latterly. it 16. " Cl Clean-up and removal of all job-related debris Including excess materials.(Extra materials are shipped with each job to avoid delays). Manufacturers warranty will be sent upon completion d installation. Additional scope of work: Duplex home,this contract is for 133-A only. 10%deposit upon order,45% upon delivery, 45% upon Completion. Does not include shed or replacement plywood or boards. Customer requests spring install. lit.maradikRgmail.com "DO NOT SIGN THIS DOCUMENT IF THERE ARE ANY AREAS LEFT BLANK" Customer(s)Inmals APPROXIMATE START DATE and APPROXIMATE COMPLETION DATE:The work will start approximately Spri no '24 (Apple Start Date)and will be substantially completed by approximately days (Approximate Completion Date).These dates are subject to change at the time the contract is accepted by WO Home Improvements or at any other time by mutual written agreement Customer understands that the Approximate Start Date is only an estimated date and the Customer will be contacted prior to this date to schedule the actual start date. The TOTAL PRICE inducing al labor,material,taxes and any applicable discount Is$ 12,5UU.U U Contract p $ 12,500.00 Initial Payment(not to exceed 50%of Total Price unless Special Order)$ 1,250 .00 de p. Final Payment(balance payable upon completion of job)$ 5.62.5.00 delivery Local Clew Tart( %) f aPayment is due prior toMHl 5,625.00 complete Theiniti ordering prodkxXs. Total Amount Due f 12,500.00 NOTICE TO BUYER:YOU,THE BUYER MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY(FIFTH BUSINESS DAY IN ALASKA,FIFTEENTH BUSINESS DAY IN NORTH DAKOTA IF YOU ARE AGE 65 OR OLDER)AFTER THE DATE OF THIS TRANSACTION. Customers)Int* CONTRACT APPROVED Customer(s)Signature mI Date_+� ,Ja�� 3 BY Date i.22.-Z9ZY ACCEPTED BY MAJOR HOME IMPROVEMENTS Project Consultant ACORD® EVIDENCE OF PROPERTY INSURANCE DATE(MM/DD/YYW) 12/29/2023 THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW.THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE ADDITIONAL INTEREST. AGENCY PHONE COMPANY INC.No.ExU:888-850-9400 Travelers Indemnity Company Marsh&McLennan Agency LLC-New England One Tower Square 100 Front St,Ste 800 Hartford,CT 06183 Worcester,MA 01608 FAX E-MAIL (A/C.Nol:866-795-8016 ADDRESS:MMA.NewEngland.CLines@marshmc.co CODE: SUB CODE: AGENCY CUSTOMER ID#: INSURED LOAN NUMBER POLICY NUMBER Commonwealth Electrical Technologies,LLC 6604F117215 Duquette Realty Trust 125 Blackstone River Road EFFECTIVE DATE EXPIRATION DATE Worcester MA 01607-1491 CONTINUED UNTIL 01/01/2024 01/01/2025 TERMINATED IF CHECKED THIS REPLACES PRIOR EVIDENCE DATED: PROPERTY INFORMATION LOCATION/DESCRIPTION Location 1 -125 Blackstone River Road,Worcester,MA 01607 Location 2-992 Bedford Street,Bridgewater,MA 02324 Location 3-6 Dexter Street,Worcester,MA 01601 Location 4-125 John Hancock Road,Unit 4,Taunton,MA 02780 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 EVIDENCE OF PROPERTY INSURANCE 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. COVERAGE INFORMATION PERILS INSURED BASIC BROAD X SPECIAL COVERAGE I PERILS/FORMS AMOUNT OF INSURANCE DEDUCTIBLE Location 1-Building Coverage $2,364,310 $1000 Location 1-Business Personal Property $551,250 $1,000 Location 1 -Business Income&Extra Expense $250,000 72 Hours Location 2-Business Personal Property $220,500 $1,000 Location 3-Building Coverage $3,504,822 $1,000 Location 3-Business Personal Property $3,150,000 $1,000 Location 4-Business Personal Property $300,000 $1,000 REMARKS(Including Special Conditions) RE:Willamsburg Solar 699 East Street Williamsburg,MA 01096 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. ADDITIONAL INTEREST NAME AND ADDRESS ADDITIONAL INSURED LENDER'S LOSS PAYABLE LOSS PAYEE MORTGAGEE LOAN# Town of Williamsburg 212 Main Street AUTHORIZED REPRESENTATIVE Northampton,MA 01060 ACORD 27(2016/03) ©1993-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD