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17A-240 (7)
M'ty of Northampton Mail CSL l:nfon,ation Heim. mall geode corn rmail,r 0 :r( siil=3921 ..3d&vlewmet&se... / n --- le -icy 2f4k aity al ItJ % ,- •a�,,.o , -(, Charles Miller comil r o- zm 208> 1 message Victoria Junck <viunck@solarcity.come Tue, Jun 7, 2016 at 12:11 PM To' "Charles Miller(cmiller@northamptonme gov)" <cmiller@northamptonma gov> Good morning Chen, ,,,,L,,_ I am emailing you in regards to several permits that we have open with the City of Pitt held. We need to get the CSL information changed on the building permits for the following addresses: C60 Lake St(Florence) 11 Acrebrook 386 Bridge Rd 25 Hinckley St 20 Fruit St The CSL information that the above need is be switched to is Jeremy Graves 604 Silver St Agawam, MA 01001 CSL 4' 108706 Type: U Expiration Date_ 02/23/2019 Contact number 774-279-7650 Victoria Junok Permit Coordinator I SoiarCity oI 2 67 61- q 1'iS PM ,atllo 9 aitpailitifAttplt11"1,) '9. .I1IpI,1eui I ou.o ldl)1 '} 961.11.)Kuck!F4!,)-(' maw IIeclair Amilt mtl 7 iiiiitli JO peon :(men apa!a) iCii.toiptiy iinnasl ___. • 1.ulaar ni.ral .-_—.- _-.__._ 1I• . 1/11 I _ _ . . liJ)DJ,.m Al!,) popiffs mom m alu.Iil(Idlaldlbna d9.ne'n•uoApp nl 4pin!On my '.1%Iln astrm yro • au() 7....a.*:,- ri 11 T•1-G( ., , In . .S Lf G! 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[J xuonlppn 10 cl!utlau lunnaol•.I tau( paq.vasa akin)st.npJo ('ponnhai St!poi uo!)mod ro3 c NU 3lµ ❑ -s Inuwnvtu •J11.103 ,sial_in. °NI IIO!lgile Yh!ppng LI 'a notncnlsiu '11nu3 smyma) 'Apaedun AUL II!au anf iliy,ox uop!louiop Q .e aniii s.ontutuoagns 3xmy,, saa,Colduia OH 3Aeq pue elms Yn!pluuia)l El .(, t 'taa,s pmptme alp uo pans -LAKJIId JO 10):11.1(101L1alns a mal ! 0'4 s,Kpupma-apes 341 plop! aua •-(aUi -IJlld.urypun (li )saario,duio uupn.gsuua.nab U vJ I pun lu)arJItIOf pssmiay II LIa I I _I b tJo09 ria%aa,kidiue a um I ©-I :(pauitha.r)laafoad Jo a1.4 :sot alm.idu.oidu awl liaaw:)i.aacojdun in mu(ani 69VZ-99L-888 :u aUoticl ZOfl6 V0 `O31VW NVS :`dr/P"s1410 AVM M3IAHV310 450E :ssaippi/ 'da00 AllOdV10S :OW'PIipw/uanw!UI lglssalnsnW atnfN Mg!aa-1 sup,! ascal,l no!teul.Io)e1111113 udV , . a(luintalane!lupaliJsaoaav..t;lwD/s.Ialrylnfl :ynspJV aan1JIISnl Irollesua(iu(o:) sia-doM �,n":114.6 491 �A�Is/,aN✓ifwi(��MY/,''�'1 u1p�InI�•stnm•nlaml111E0 1,1414901v0P1 o Q WAJS 00010100/11009 . 411.;!1',:= Iti sunt/nN,,%D4 JJII amigo ='M ' 2 �' .5yw)pra.)y 1n1Aanrytry 0 JuaruJand.)p• 11'-.'2 -wasnspo sn;vfn 711namnoutut ,) aqj ` ' I A CERTIFICATE OF LIABILITY INSURANCE ce'�/2015 1 11 r 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 POUCIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTAW t OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: II the cedNkate holder is an ADDITIONAL INSURED,the pollcylles)must he endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement Mn this certificate does reet confer rights to the eerdpcate holder In lieu of such endorsamentis). PROOIJC R CONTACT AURSI4RISr&INSURANCE SERVICES MANE PNtlE • LALIFFORNIA LICEALIFCRNA NSE NO.�53TREET.SUITE UT E •taU. _. EXILE'S SANFRANCISCA 94104 - CO _ AM'Shaman SWU415713A131 SPRE Ls1AFFORDMG COYEAAGE _ Nam 999391SOS GAWUE-1516 MBVRERA Zurich M too Insurance Company 46535 INSURED INSURER B:NIA NM Ere1rCRy Commalin f 'e✓SDv eawWay NSVREA c.NIA _. . at _. Sm Mato,CA 94402 NNRERD AlmrvaArch rch lawman Cnnpem x40142 INSURER ♦ .. INSURER F: I COVERAGES CERTIFICATE NUMBER: SEA00I71313360/1 REVISION NUMBER:4 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NWLMTHSTANOING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT VIN RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Dpayawl OUCYEiTPo T ALTRJ TYPE OFINEIRANCE ma LN9 FgICY NUMBER 11111/ONYYTTEMp FYYTY I UmTS X 1 COMMERCIAL GENERAL UP&NTY GL03192016.90 09/0t(2015 !OW/2016 EACH OCCURRENCE S 3.000.400 {I I � PREMISS CE EnmL S 3000000 1 CLAMS X OCCUR X SIR S259000 NEO EXPIAR Ho 554=49 s 5000 PERSONALS ADV INJURY 5 2200000 GFHL AGGREGATE LIMiLAGRIESPER GENERAL AGGREGATE 5 6I00CL'0 X 1{POI£C1 POLICY L ri !LOc fPROOJC S COMP/OR ASO4 3 6400000 l (Ina I Is A AtMOMOaLE UAf.m BAP01310I7-00 00112019 099112016 GDPARNED SINCLE LINA S 5090000 .1ER see X :ANY AUTO I BC0LY INJLRY1Fk perstm $ X ALTOS EO X SCHEDULED AUTOS BOLLYINJURY(Per am0aR1 I • X FIRED AUTOS X AUTOS HUTOS EO PROPERTY DAMAGE S PH 1 CO :Seat DEO. s 55.00 UMBRELLA UM I OCCUR EACH OCCURRENCE S _.. EXCESS UAB 1CWMSNADEI AGGREGATE 1 DED IA IRETENPONS 1 r I IS O women coaaasiml ! 00182014.00 IROS) 0901/1015 0901/2016 `X.I RARtt 1 10TH I Aro EMPLOYERS'LIABILITY I.. A ANY PRWRETCINPARTNEReXECu1IVE IPIINNI TVC)1E2015C11(MA) 00.01/2015 '0901/2115 EL.EACHACOOENT S 1,050000 oRCERIUENeEn ENCLVUEm I NIA 4C DEDUCTIBLE-90000 I ' 1,000,'300 Mandatory In CIN EL®SE/SE•FA FIIpLOYFg1S IlaSCPIPTIN OPERATCNS baba I E DISEASE-POLICY LET[S I I 1 I I DESCRI.PnON OF OPFRAnONE/LOCATIONS I VEHICLES(ACOR0161.AE®mnd Remarks Schedule.may R attached flmom gage Is rtPMedI EQante Simla .. CERTIFICATE HOLDER CANCELLATION SaNrdYG=WrMMm1 SHOULD ANT OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 39E6 Cbnew Way THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED W San Ma00.CA 99402 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPREBENtATYE of Marsh Risk a Insurance Services Chanes Memoejo .CZ_ /ma. iK--S I 01988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/011 The ACORD name and logo are registered marks of ACORD a '';, r , ,,,, rrl714 , (�., . . , , Office of Consumer Affairs land Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration • Registration- 168512 Type: Supplement Card SOLAR CITY CORPORATION Expiration: 3/8/2017 JEREMY GRAVES 3055 CLEARVIEW WAY SAN MATEO, CA 94402 Update Address and return cord. %lark reason for change. Address Renewal Employment Lost Card Office of Conaaner Affairs d Rosiness Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration dote. If found return to: Orfire of Consumer Alftin and Business Regulation Registration: 168572 Type: 10 Park Plaza-Suite 5170 Expiration: 31812011 Supplement nard Bastin,MA 02116 SOLAR CITY CCRP!)NAI v W JEREMY GRAVES 24 ST MARTIN STREET ERG 2UNI <4Sd—.;—>.8i -- PIARLBOROUGH.MA 01752 - Undersecretary Nut valid without signature • s. .. CS-108706 A JEREMY GRAVES blb 179 BRIGHAM STREET Mad borough MA 01752 `72.-• 02/23/2019 C171( JJ/a/o �r i/rocl/// o/ 11(1.;.4/1.5(1() Office of Consumer Affairs And Businegulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 168572 Type: Supplement Card Expiration: 3/8/2017 SOLAR CITY CORPORATION VICTORIA JUNCK ---- - -- - ------ 3055 CLEARVIEW WAY --- - ----- - - SAN MATEO, CA 94402 Update Address and return card.Mark reason for change. i 7C1.1'F.�.. Address - Renewal Employment -- Lost Card <r,--Office ofConsumer Affairs&Business Regulation License or registration valid for individul use only yME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 'Registration: 168512 Type. 10 Park Plaza Suite 5170 Expiration: 3/8/2017 Supplement Card Boston,MA 02116 SOLAR CITY CORPORATION VICTORIA JUNCK 24 ST MARTIN STREET BLD 2UNI & ' RAARLBOROUGH,MA 01752 Undersecretary Not valid without. _ amre ie _,,i_ SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: I Not Applicable 0 Name of License eotdar:SOLAP.CITY/JEREMY GRAVES 108706 License Number i 604 SILVER ST AGAWAM MA 01001 02/23/2019 Address Expiration Date 774-279-7650 Signature Telephone 5.Renistered'Home.improvement Contractor. .. Net Applicable 0 SOLARCITY CORPNICTORIA JUNCK 168572 Company Name I Registration Number 604 SILVER ST AGAWAM MA 01001 103/08/2017 Address . Expiration Date Telephone 978-215-2367 SECTION 10-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 buildino permit. Signed Affidavit Attached Yes C No 0 11. _ Bate Owner Exemption The current exentptior,for"homeowners"was extended to include Owner-occupied Dwellings of one(I) or two(2) families and to allow such homeowner to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor.CMR 780. Sixth Edition Section 108.3.5.1. Definition of Homeowner:Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two family dwelling,attached or detached structures accessory to such use and!or farm structures.A person who constructs more than one home in a two-year period shall net be considered a homeowner. Such"homeowner"shalt submit to the Building Official,on a form acceptable to the Building Official.that he/she shall be responsible for all such work perforated under the huildipkpermit. As acting Construction Supervisor'your presence on the job site will be required from time to time,during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152(Workers'Compensation) and Chapter 153(Liability of Employers to Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,you may he liable for person(s) you hire to perform work for you under this permit. The undersigned`homeowner"certifies and assumes responsibility for compliance with the State Building Code,City of Northampton Ordinances,State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature