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17C-105 (3) 71 HIGH ST BP-2017-1163 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: I7C- 105 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:BATH KENOS BUILDING PERMIT Permit# BP-2017-1163 Project# JS-2017-001964 Est.Cost: $45478.00 Fee:$295.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: THOMAS DADMUN 107919 Lot Size(se. ftJ: 6446.88 Owner: LOCOCO MARIE D&MARIE AUGUSTINA LOCOCO zoning: URB(100)/ Applicant: THOMAS DADMUN AT: 71 HIGH ST Applicant Address: Phone: Insurance: 60 SCHOOL ST (413) 387-7381 HATFI ELDMA01038 ISSUED ON:4/21/2017 0:00:00 TO PERFORM THE FOLLOWING WORK:CONVERT A 1ST FLOOR PANTRY INTO A LAUNDRY/HALF BATH AND REMODEL 2ND FLOOR BATH 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: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: FeeType: Date Paid: Amount: Building 4/21/2017 0:00:00 $295.00 212 Main Street, Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2017-1163 APPLICANT/CONTACT PERSON THOMAS DADMUN ADDRESS/PHONE 60 SCHOOL ST HATFIELD (413)387-7381 PROPERTY LOCATION 71 HIGH ST MAP 17C PARCEL 105 001 ZONE URB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid (� Building Permit Filled out U� Fee Paid f Typeof Construction: CONVERT A 1ST FLOOR ANTRY INTO A LAUNDRY/HALF BATH AND REMODEL 2ND FLOOR BATH New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 107919 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ION PRESENTED: pproved Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Permit With Site Plan Major Project: Site Plan AND/OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit _ Variance* Received& Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health _ Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission Permit DPW Storm Water Management 4 /�'1 7-2O -17 Signature of Building O mial Date Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health,Conservation Commission,Department of public works and other applicable permit granting authorities. *Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of Planning& Development for more information. City of Northampton Building Department -" A 212 Main Street Room 100 Northampton, MA 01060 phone 413-587-1240 Fax 413-587-1272 APPLICATION TO CONSTRUCT,ALTER,REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: /..mss ontcm Wane .f I '�(aH Sl. Map f,t V-4/C0(061-Li F1A OVAL((2, Zan Oyedayrtishict Bn St.District . t(C1130140cf SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: MA,Ltk \- 11 Ef1(A fir, clltt c 4 0/0(02 Name�(Print) Current ailing Address' 3 51-2351 Telephone Signature 2.2 Authorized Agent T1b(IA hs D/h)r+)4.1 bo ''1AkvvL. 5Y. N-kslgfa,bl ( 45% Name(Pri t)/ ) r Current Mailing Address: JVt4A/V-<2-- 6 - 13- 3M- 23ti=( Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building f Y21 (a)Building Permit Fee 2. Electrical 3 p ,/ e 0 (b)Estimated Total Cost of L,I Construction from(6) 3. Plumbing 4 q roc, Cu Building Permit Fee I 4. Mechanical (HVAC) ug 5. Fire Protection ;��y� 6. Total=(1 +2+3+4+5) 4 45)41?) ‘7.4 Check Number G This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner/Inspector of Buildings Date Section 4. ZONING Ad Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size — _. .._..... ..._. Frontage Setbacks Front l i Side L•_ 1 R:_.... LI_ R . __� .... _"'. Rear __: Building Height _ _..___ i ' Bldg. Square Footage --' - % fi Open Space Footage _ % � I (Lot area minus bldg&paved 1 1 ._ parking) is of Parking Spaces i --- J Fill: (volume&Location) _ _L._ _. A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DONT KNOW O YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES O IF YES: enter Book I Page and/or Document#1 B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW O YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained O , Date Issued: C. Do any signs exist on the property? YES O NO IF YES, describe size, type and Location: l D. Are there any proposed changes to or additions of signs intended for the property? YES O NO O IF YES, describe size, type and location: I E. Will the construction activity disturb(clearing, grading, excavation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES O NO O IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ® Roofing n Or Doors O Accessory Bldg. ❑ Demolition 0 New Signs [I7] Decks [q Siding [C] Other[C] Brief Description of Proposed Work: cow) A r c, Ftoq- PA\aif-1 Nato R 4)011(2,1 OWPt n / o IZEPODIL. Z`° FAst. CM-y 4o"t Alteration of existing bedroom Yes X No Adding new bedroom Yes k No Attached Narrative Renovating unfinished basement Yes ZC No Plans Attached Roll -Sheet ttt -i t Iu`"t4.1.r. r. 1$! w,e--J u:•rA« ni [.r . itrt .,'alit•:: a. Use of building :One Family / Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction i. Is construction within 100 ft.of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No . I. Septic Tank City Sewer Private well City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, M- t- LO6OGo ,as Owner of the subject property �-, hereby authorize k L. 9JNMV0 to act on my behalf, in all matters--prelative to work authorized by this building permit application. ))14triz Cl, YLvec-txr Afry(L 17, 2017 Signature of Owner u,. Date lr^OI"yA'S E 4)1i/too , as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Th AkS E- Oko]"vJ Print Name — /Vt L f7, 1af7 Signature of Owner/Agent Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor:- thfi7Mq Not Applicable ❑ Name of License Holder: t °hOVS 2 �ti CS - 107 (j License Number (OC (iekwL St tMtcnu,tz VrR Blom; 1124 I2Ei7 Addres Expiration Date w J1c-DL 413-367-7Sbt Signature Telephone SS ._ florae ..�,. , r` .,a;.1' Not Applicable ❑ € tuck- Loa.)? 1.4-.6 11oS).. Company Name Registration Number (00 &u+DtL St. 025/Zzlb Address Expiration Date 1 tt,g, AR OfO3p Telephone 413-bYi1-73e, 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 building permit. Signed AffidavitSttAttached Yes ff No .❑ IL trig ". vc.-VI:- •1�tgttal The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) 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 not be considered a homeowner. Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official that he/she shall be responsible for all such work performed under the building permit. 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 be 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 Massachusetts -Department of Public Safety Board of Building Regulations and Standards (I in'!rucuon Sup.n'stir License: CS-197819 THOMASDADM1N MISCHOOL STREET Q,. 419 Hatfield MA 918 , d 17:4.—-ry„ Expiration Commissioner 99/24/2917 rYk fo/1n aontesea7/A oh f6u ac%ereal E Office of Consumer Affairs and mess Regulation 4. 10 Park Plaza - Suite 5170 Boston, Massacusetis 02116 Home Improvement Loot actor Registration >. Registration: 179682 Type: LLC Expiration: 5282018 Tri 419291 THE TUCKER GROUP LLC. THOMAS DADMUN 60 SCHOOL ST t" - — HATFIELD, MA 01038 -, 2 Update Address and return card.Mark reason for change. Address 'T Renewal Employment (- Lost Card 0CP, 0 2JugSn -" `- '/GoYQ/s? F(..irckwdY. Office of Consnmer AOkin&Beinmss Regulation License ort cn:suscion valid for individual use only v HOME atlooIMPROVEMENT CONTRACTOR before egpwadoe date. If Med rears to: q ` RpNbaOaa: 179682 TON: Office of Consultor Affairs and Business Regulation --• 10 Park Plaza-Suite 5170 -y, ;:z Eapintoes 8:2&2018 LLC Boston,MA 02116 THE TUCKER GROUP U-, THOMAS DADMUIF. . ;• 60 SCHOOL Si HATFIELD,MA 01038 Undersecretary Not valid without signature Aco o® CERTIFICATE OF LIABILITY INSURANCE DATE(MWDB"T") 4....-/ 12/14/2016 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(5),AUTHORIZED REPRESENTATIVE OR PRODUCER.AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must 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 COMEACT Susan Fleury, CIC, CISR King & Cushman Inc. o NE o Eet$ (413)584-5610 IIMx xnl:14111 sett-razz P.O. Box 447 ADDRE "AILgo SFleury@ICingCllshman"corn 176 King Street INSURER($}AFFORDING COVERAGE NATO it Northampton NA 01061 !nausea A Hain Street America Assurance Co. 29939 INSURED INSURER B: DADNUN DESIGN 6 CONSTRUCTION INSURER 0: 60 SCHOOL ST INSURER D: INSURER 5: HATFIELD 16A 01038-9747 ENSURES,: ' COVERAGES CERTIFICATE NUMBER:CL16121401819 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 RECUIREMENT, 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 ADDLlUBR POLICY EFT POLICY X2 LTRJ*LSD WUD POuCY NUMBER IMMIOOR'/YYI IMMOOMNY1• UNITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-WOE X OCCUR DAMAGE TO RENTED 500,000 REMISES<EaENTEO E MPP4694Q 11/13/201611/13/2017 MED EXP(Any we person) $ 10,000 I PERSONAL&ADV INJURY $ 1,000,000 GEM.AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE g 2,000,000 X POLICY !Eo- LOC PRODUCTS•COMP/OP AGO I.E 2,000,000 OTHER: Identity RecOVHy Ig AUTOMOBILE W&lfry (CEOMBBIIN dent( LJ INT LR $ ANY AUTO BODILY INJURY(Pepecall $ :ALL OWNED SCHEDULED BODILY INJURY(Parm4ent) $ 1AUTOS _ AUTOS NON-OWNED ".. PROPERTY DAMAGE '$ HIRED AUTOS AUTOS (Per accident} UMBRELLA LAB ' OCCUR EACH OCCURRENCE $ EXCESS DAB CLAIMS-MADE AGGREGATE $ DEG I RETENTIONS $ WORKERS COMPENSATOR PLR 0Th- AND MAND EMPLOYERS'LABN1fY YIN STATUTE ER ANY FROPRIETORNARTNER,EJIECIRIY£ - EL EACH ACCIDENT S OFFICERMEMRER EXCLUDED? N/A (Mar dnoryln NH) EL DISEASE-EA EIPLOYEE $ If yes,Comte',rider DESCRIPTOR OF OPERATIONS below aL DISEASE-POLICYLIMR S • 1/ESCNP110N OF OPERATORS/LOCATIONS/VEHICLES(ACORD 101,AStlional Rn,nts Schelde.may M attached W more Wats Mtemdmd° 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 I PROVISIONS AUTMORIffG REPREBENTATNE N •y��.. IILMENY.. I l /Y� . _tA lV1�. 01..- n : t.# ..All d:hta ed. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201441) City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111 , S 150A. Address of the work: 'it 141(>vi St, 'L2ctUCLi Y'}4 Fibb(02.. The debris will be transported by: Alltft,PATIvt. Ptcycuocr The debris will be received by: Building permit number: Name of Permit Applicant Tlfow As D{ft>wthJ Date Signature of Permit Applicant The Commonwealth of Massachusetts r— Department of Industrial Accidents R—"_ e— e_a Office of Investigations t Nita' — I Congress Street, Suite 100 "-�;— Boston, MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant InformationPlease Print Legibly Name (Business/Organization/Individual): 2 DMUk: Dt //��SLfr/J r terJSZur,Do3 Address: (cc 94tOL Sj', Otif Ito, 044 blo3,6 Phone #: 113 -367-73&1 Are you an employer? Check the appropriate box: Type of project(required): L❑ I am a employer with 4. j p� I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. Nev❑ construction listed on the attached sheet 7. Yy Remodeling 2.❑ I am a sole proprietor or partner- ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.' required.] 5. ❑ 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.] * c. 152, §1(4),and we have no employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box/41 must also fill out the section below showing their workers'compensation policy information_ *Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. t'Contrdctors 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: Policy#or Self-ins. Lic. 4: Expiration Date: Job Site Address: 1t H'6$ eSt, City/State/Zip: FG(lkx 1 M4 0(o(at 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 S 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 5250.00 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 certif under the pains and penalties of perjury that the information provided above is true and correct. Sia ature: ww' hz— / VDate: AiR6f 17, k17 4 Phone#: 13 - btif- 1bU 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 4: DADMUN Design + Construction Project Address: Subcontractor List 71 High St 4/17/2017 Florence, MA 01062 Subcontractor: Has Employees: Yes No SMG Plumbing and Heating X James Elkins Electrician X Paul Ayotte X SDL Home Improvement X Right Way Drywall x Cortina Tile X A CERTIFICATE OF LIABILITY INSURANCE DATE(M7D(YYYY) 9/16/2016 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(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on tills certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAMES Elizabeth Carballo Pinch & Perras Insurance Agency Inc. PHONE �(d13)527-5520 I� No). 4U)52?-5970 •6 Campus Lane E ADDRESS:bcarballo@finokandperraa.com INSURER(S)AFFORDING COVERAGE NAIL AL Easthampton MA 01027 _ racemRAArbe11a Insurance Group 17000 INSURED INSURER 0: S M G Plumbing & Heating INSURER C: 133 Wyben Road INSURER°; _ INSURERE: Westfield KA 01085 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1691602490 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 CONDRION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY 3E 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. INSRI ADOU$SB0. POLICY EPF POUR('EXP LTR TYPE OF INSURANCE NSD', POLiCY NUMBER (MMNDIYWYI (MMNORYY0 LWRS X COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE $ 1,000,000 �� DAMAGE-10 REED $ 50,000 A CLAIMS-MADE LT J OCCUR PREMISES(Es eccuslHFB1 9520042004 9/4/2016 9/4/2017 MED EXP(Any one person) $ 5,000 PERSONAL P.ADVIN.URY $ 1,000,000 GEML AGGREGATE OMR BAILS PER: GENERAL AGGREGATE $ 2,000,000 X RoneyPRb LOCRIODLCTS-COMPIOP AGG $ 2,000,000 GIBER: $ AUTOMOBILE UABILT' CCI NLDD(SINGLE LIMIT $(Ea accident ANY AUTO I BODILY INJURY Per peraM.) $ ALL :ALL OWNED AUTOS ED .. BODILY INJURY(PererslOev E AUTOS NON-OWNED I PROPERTY DAMAGE', .$ I AIRED AUTOS ___, AUTOS .(PIN egging UMBRELLA IAB FA _ OCCUR CIE OCCURRENCE $ EXCESS LIAB j CLAIMS—MADE AGGREGATE $ DED RETENTION S. $ WORKERS COMPENSATION PER OTH- ANDEMPLOYERS'LIABILITY Y)N STATUTE ER_ - ANY PROFRIFTORPARTNEPJFXECLTIVE NIA EL.EACH ACCIDENT I$ OFFICER/MEMBER S(CLCO-1? (Mandatory In MO EL DISEASE-EA EMPLO $ It mc..debate Inca DESCH..PTION OF OPERA-INS otlw EL.DISEASE-POLICY LIME $ 1 DESCRIPTION OF OPERATIONS I LOCATORS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attathed if more Mince Is required) Proof of Coverage CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Tom Dadmun / D+C THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 60 School St. ACCORDANCE WITH THE POLICY PROVISIONS. Hatfield, MA 01038 AUTHORIZED REPRESENTATIVE z E Carballo/BETH — f�K� '"����� ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(2C14D1) A CERTIFICATE OF LIABILITY INSURANCE % ° �`"s�l 16� THS 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. THS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT: A the certificate holder is an ADDITIONAL INSURED,the hoticybee)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may rewire an endorsement. A Statement On this certificate does not confer rights to the certificate holder in lieu of such erdortsnenys). PROOICER NAMTN.T NAME: Bresnahan Insurance Agency, In PRONE taX (433) 534-4241 100 Whiting Farms Road F.LAi'Ear LAl3} 536-0$36 M.<xn. ADDRESS: Holyoke, MA 01040 INSURERS)APFORDIN;COVERAGE NINON I/anima:Map£re/Commerce Insurance Co. ThSURED LL INSURER e: James Elkins INNIIRERC- 2 Williams Street INSURER o: Holyoke, MA 01040 INSURER E: .....n -.. INSURER F: _ COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICES OF INSURANCE USTED HELM HAVE BEEN(SEED TO THE INSURED NAME,ABOVE FOR THE POLICY PERIOD INDICATE. NOTW THSTANOING ANY REQUIREMENT,TERM OR CONDITCN OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED DR MAY PERTAW,THE INSURANCE AFFORDED BY TIE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYRE OFINSURAx� � VBR P�10 LY 1LTTRR. INSTWO pesos MOMER MMOSPNYV)Osumi I UMTS A ' GENERAL LIABILITY Y1407550 5/5/1.1 5f5/3T EACH OCCURRENCE 5, },000,000 I I °LANCET°RENTER X,ca.Teesexe GENERAL T wetITY 1• PREwcFS IFI, ,.,-Rr i5 100,000,_ CueA$MAOE X!OCCUR GENERAL NNAEXP LG 1 5 0,OOQ �� Po re pasL1r a „},0 .5.000,..._ _ I AGGREGATE 5 2.000-,000 IGENT AGGREGATEL OLT APPI,IESPER i PRODUCES-COPU'JPAGG 5 2 000,Deo ' X FOI AERN I ' L CY i6 1 - 5 r AUTOMOBILEUABIUTY (Ea INNLD SINGLE TN 5 ANY WO j BODILY NJURYIVe ,rem) ,3 PIL LJ LE WFEO 5GNEOUO 900LY[BARYONras Cenp 5 NOOWNED 1 t ''PROPERTY MNK£ I5 WREDM`TOS _ AUTOS 1,per a¢trx) { $ A IVMBRE4Loa _occue EAR ' N OCCURRENCE $ - -1 EXCESS LIAR CLAHAS{MWI AGGREGATE IS DEO RETENTIONS 1 • 15 i MARKERS CC ENSATLON 1 I WC StA TV USI )FR ANDEMPLOVERe Ow n-T Y(N MY.FRCONSC1RARTl:ERIE%EGJTA4 tEL.EACH ACO SENT ;5 OFFICER4AENoER EXCLUDED' NIA (Mardatmy in NN) 13I I F.L DISEASE,EA°MPLOYEE3 ' Ir .tlmwibe older DS6RIPLIYOA OF OPERATIONS LNILIw _ _ EL DISEASE-POLICY LIMO 5 I 1 I NESCRIPTION OFOPERATONS I LOCATIONS/VEMCLES (Mach ACORN 101,Atltiuone RemMs CAERE,if more since Esmond) Electrician CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF RiE ABOVE tie SCRIBED POUCES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED M Dadaun Design & Construction ACCORDANCE WITH THE POLICY PROVISIONS. 60 School St. .M� Hatfield, MA 01030 AU 't. -. "+= ATrvE E I I 1019SSd010ACORD CORPORATION. All rights reserved. ACORD Z512010100 The ACORD name and logo are registered marks of ACORD Phone: Fax: E-M&:: tomd@dadmundo.cot A o CERTIFICATE OF LIABILITY INSURANCE DATE D3/2/11 THS 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. THS 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 policy0es) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A staIemert on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PMOLLCER CONTACI NAME: Dale A Frank Insurance Agency, HONE rax ENL Far (413) 665-8324 arc,xa: (413) 665-12e0 PO Box 455 ADDRESS: info@DaleFrankInsurance.com Sunderland, MA 01375 INSURE RS)AFFORDING.COVERAGE NAM i INSURER A:SCU - Western World Ins Co INSURED INSURER B: I Paul Ayotte INSURER c: - - PO BOX 1063 INSURER D: 92 Laurel Park -- -- _ -_ — INSURER E: Northampton, MA 01061 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. NOMMTHSTANDING 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, EXCLUSONS AND CONDITIONS OFSUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAD CLAIMS. INSR ADJL'BUBR POUCY EFF POUCY EXP I - - LTR TYPE OF INSURANCE NOR WVO POUCY NUMER I immicorryvvi IM.hmD'YYW)'I LINTS A GENERAL LIABILITY NPP8411352 2128117' 2/28/181 EACH OCCURRENCE @ 300,000 X COMMERCIAL GENERAL LIABILITY I PRFMDAMAIETOREMEO I DAFAlGET RENTEDncei._._S 100,000 CIAIMSMADE OCCUR 1 MED EXP Very ore person) S 5,000 PERSONAL&ADVnNIURY $ 300,000 GENERAL AGGREGATE $ 600,000 GEN'L AGGREGATE LIMITAPPLIES FE le . PRODUCTS-WMPIOP AGG S 300,000 POLICY PFRO LOC AUTOMOBILE UASIUTY 1 ' ' COMBGNEED51NGLELIMIT $ ANY AUTO BODILY INJURY(Per person) S ' ALL OWNED SCHEDULED BODILY INJURY(Per xciaeni)I $ 1 AUTOS AUTOS AUTOSS ED PROPERTY DAMAGE $ -- HIREDAUTOS AUTOi (Pe a9� S UMBRELLA LIAO _OCCUR I . EACH OCCURRENCE ' S EXCESS LIAR CLAIMS-MAW ' ''.AGGREGATE $ DED RETENTIONS 1 S YORKERS COMPENSATION ' WC STATU- ' .0TH- ANO EMPLOYERS'LIABILITY TORY I!MITAR ANY PROPRIEIOR/PARTNERIEXETAIPVE YIN 1 OFFICERMEMBER EXCLLDED? N/A ' .EACX ACCIDENT S (Mandatory in NH) E L.DISEASE-EA EMPLOYEE S IY 0¢oiLe under DESCRIPTIONCFOFERMTIONSCalow ' EL.DISEASE.POLICY LIMIT S W SCRIPION Of OPERATIONS f LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,Hmore space is regd red) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED W Tom Dadmun ACCORDANCE WITH THE POLICY PROVISIONS. 60 School St Hatfield, MA 01038 AUTwoRIZED REPRESENTATIVE Matthew Brown ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The AC ORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: A`�CI CERTIFICATE OF LIABILITY INSURANCE DAT/3/201GIMIDDJYIrrl 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 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 Cynthia Henderson, CISH NAME: yn a Webber & Grinnell PHONE (413)586-0111 FAX C NoL(412)ses-64e1 8 North King Street RFSS:Chenderson@webberandgrinnellll.COID D INSURERIS)AFFORDING COVERAGE NAIL* Northampton MA 01060 INsuRERASelective Ins Co of S Carolina INSU D INSURER B:Se1CCt1Ve Ing CO of Southeast 39926 SDL Home Ome ImprOVement Contractors Inc. ,INSURER L:_ 24 Chestnut Street I INSURER D: INSURERE: _.I Hatfield MA 01038 INSURER F: COVERAGES CERTIFICATE NUMBERHaster 2017 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. NOTIMTHSTANDING 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. TNSSR IADDLISLIBR - POLICY EFF POLICY FXP rya TYPE OF INSURANCE I INFO I WV) POl1LY NUMBER IMWDOMIYY) IMWDDM'YYILIMITS X 'COMMERCIAL GENERAL LIABILITY I I L EACH OCCURRENCE S 1,000,000 A CLAIMS-MADE X OCCUR • ' PREMISESPREMISES(Ea a occurrence)cTEC 100,000 RENTED $ 52204065 2/1/2017 2/1/2018 MED EXP(Any one person) $ 10,000 PERSONAL SADV INJURY s 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER 'I,GENERAL AGGREGATE $ 3,000,000 X PDUCYJET •_ LOC PRODUCTS-COMPIOPPGG $ 3,000,000 OTHER: _.._ 5 AUTOMOBILE LABILITY • COMBINED SINGLE LIMIT 5 1,000,000 A ,f Ea accident) ANY AUTO BODILY INJURY(Per person) •S ALL OWNED X_ SCHEDULED p310032e 2/1/2019 2/1/203e BODILY INJURY( Gr eCpdenr) S'AUTOS RUSWNED PROPERTY DAMAGE SXHIRED AUTOS AUTOS (Par accident) Undennsuredmolonsrs)split S 100,000 X UMBRELLALIAB X -OCCUR EACH OCCURRENCE $ 1,000,000 E%CESSLIAB 'CLAIMSMADE I I AGGREGATE $ 1,000,000 A _TE r . DED X RETENTIONS 10,000 152204065 2/1/2017 2/1/2018 5 WORKERS COMPENSATION • I X 'STATUTE X H ER AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE NIA I E.L.EACH ACCIDENT $ 500,000 R mandatorEin NLH)R E%CLUOEO'+ _y wC9024456 2/23/2017 2/23/2018 EL DISEASE-EA EMPLOYEES 500,000 1 aesc e ..—. V Mer DESCRIPTION OF OPERATIOrvS below EL DISEASE-POLICY LIMIT 5 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached Xmore space is required) The Workers Compensation policy does not include coverage for Paul Schmidt, Kendrick Dempsey and Douglas Schmidt. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE DADMUN Design + Construction THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 60 School Street ACCORDANCE WITH THE POLICY PROVISIONS. Hatfield, MA 01038 AUTHORIZED REPRESENTATIVE C Henderson, CISR/CIN ISpNMa+->a V.- -•...-- ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS023 rmrenn ACORn® CERTIFICATE OF LIABILITY INSURANCE DATE (NNIDD Y) `-..-"--- 4/3/17 THS 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(i es) must 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 Matthew Brown Dale A Frank Insurance Agency, PHONE PO Box 455 er No Em• (413) 665-8324 arc,Na: (413) 665-1280 Sunderland, MA 01375 'o iss: info@ DaleFrank Insurance.cow INSURE MS)AFFORDIIL COVERAGE NAILa INSURER A:Providence 116URED _. I IHSuIRFAe:Progressive _ Rightway Drywall Inc. INSURER C:Guard Brian Johnson _ -- INSURER O: 206 Coles Meadow Road I RwaER t: _ _ Northampton, MA 01060-1111 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 TIE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXC W SONS AND CONDTIONS OF SUCH POUCIES.LIMITS SHOVRI MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR — paC3UBR --PMh1MEFF PMICYIXP EACH OCCURRENCE LTR TYPE OF INSURANCE IINSFLIWY� POLICY NUMBER IPOLJOYYYVI (FMNcy EXP LIMB A GENERAL I,, C BOP0093210 1/15/17. 1/15/18 ! $ 1,000,000 X' COMMERCIAL GENERAL L IABwTY OAMMGETO RRENTEDD •s 50 000 _. PREMISES IF CIA IMSNADE OCCUR I MED EXP(Arm ore person) s 5,000 _ PERSONA L&ADV INJURY 5 1,000,000 __. GENERAL AGGREGATE 5 2,000,000 LIES GEMLAGGREGATE L IMIT APPLIES PER I PRODUCTS_COMP/DP AGG 5 2,000,000_ POLICY FrT LOC . 5 B AUTOMOBILELWBIUT' 02849700-1 1/26/171 1/26/18._.N$OM NEE„SINGLE LIMIT $ ANY AUTO BODILY INJURY(Per parson) . 5 ALLOWED SCHEDULED • BODILY INJURY(Per aciuent) S AUTOS AUTOS 500,000 AUTOS NON-OWNED PROPERTY DAMAGE y _ HIRED AUTOS AUTOS s UMBRELLA LIAR OCCUR I. EACH OCCURRENCE 5 EXCESS LIAR CVJMS.MACE _ 111 AGGREGATE 5 DED RETENTIONS I 1 5 c MARKERS COMPENSATION R2WC815297 3/8/1713/8/18' 7 R - 'LOTH.. AND EMPLOYERS:LIABILITY YIN STANS FR ANY PRWRIETERPARTNEREXECUNVE I 1 E.L.L.EACH ACD CENT , 100,000 OFFICERMEMBER EXCLUDED' Ni A! I • _ I ITyees.d tory In NH) E L.DISEASE.EA EMPLOYEE $ 100,000 If O OPERATIONS below I EL.DISEASE- T POLICY UMIns 500,000 a SCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (math ACORD101,A,dNcnI Remrb Schedule,R more space is regd red) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE CE SCRIBED POLICIES BE CANCELLED BEFORE TIE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Tom Dadmun ACCORDANCE WITH THE POLICY PROVISIONS. 60 School St Hatfield, MA 01038 AUTHORIZEDREPRESENTATIE Matthew Brown ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: Client#:41601 CORTII ACORD.. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 4/07/2017 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 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 CNoAMME: Mary A.Henderson People's United Ins.Agency MA PHONE 413 781-6871 - FAX --- LNC,No,_Ex): I(A/C.No): 1391 Main Street,3rd Floor ADDRESS! Mary.Hendersan©peoples.com PO Box 4950 -- -'- - - -- Springfield,MA 01101 INSURER(S)AFFORDING COVERAGE NAIL% INSURER A'.Merchants Mutual Insurance Co 23329 INSURED INSURER B: Cortina Tile of West Springfield INSURER c 1645 Riverdale ST — W.Springfield,MA 01089 INSURER o:__ 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. NSR ADDLSUBR POLICY EFF OLJCY EXP WM - - LTR TYPE OF INSURANCE NSR VD POLICY NUMBER (MNCYYY) IY1(MMNONYYY) LIMITS A X'.COMMERCIAL GENERAL LIABILITY 1X BOPI071849 03/30/201703/30/2016 EACH OCCURRENCE $1,000,000 CLAIMS-MADE OCCUR '.. I PREMISESS(Ea occurrence) s500,000 X Blkt Al Per Prior . MED EXP(Any one ve,eon) 55,00.0 Written Contract PERSONAL&ADV INJURY S GEN'L AGGREGATE LIMIT APPLIES PER'. '.i GENERAL AGGREGATE _s2,000,000 POLICY I_^I JET O- I1 LOC I PRODUCTS-COMP/OPAGG s2,000,000 OTHER. S AUTOMOBILE LIABILITY • COMBINED SINGLE LIMIT (Es accident) $ _ ANY AUTO BODILY INJURY(Per Person) $ ALL OWNED . SCHEDULED ace/dent)AUTOS BODILY INJURY(Per aoent) $ NON-OWNED • PROPERTY DAMAGE HIRED AUTOS AUTOS (Per accident) $ A 11 X UMBRELLA UAB X OCCUR CUP9146566 03/30/201703/30/2014 EACH OCCURRENCE 51,000,000 EXCESS LIAR_ CLAIMS-MADE 'AGGREGATE _ Si,000,000 _ ' i DED XI RETENTION$10000 !. _ __ s A WORKERS COMPENSATION ER 0TH- A MPLOYERs LIABILITY Y)N ''I WCAI033448 03/30/201703/30/2018 X ''SPTATUTF I (4 ANYPROPRIETOR/PARTNER/EXECUTIEEACH ACCIDENT $500,000 OFFICER/MEMBER EXCLUDED? ,NJ E.L.NIA -- (Mandatory in RR) EL.DISEASE-EA EMPLOYEE'8500,000 if yesdescribe under !DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES)ACORD 101.Additional Remarks Schedule,may be attached It more space Is required) Blanket Additional Insured per Merchants form MU8277(1111); Blanket Additional Insured-Completed Operations per Merchants form MU8530(1111) Proof of Insurance CERTIFICATE HOLDER CANCELLATION DADMUN Design+Construction SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Tom Dadmun ACCORDANCE WITH THE POLICY PROVISIONS. 60 School Street Hatfield,MA 01038 AUTHORIZED REPRESENTATIVE "3/4.14.d do % vnRAc Afilfef O 1988.2014ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) 1 of 1 The ACORD name and logo are registered marks of ACORD #S812656/M795873 MADCT