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32A-166-010 BP-2023-1036 10 BIXBY CT COMMONWEALTH OF M SSACHUSETTS Map:Block:Lot: 32A-166-010 CITY OF NORTHA PTON Permit: Exterior Res PERSONS CONTRACTING WITH UNREGI TERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARA TY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2023-1036 PERMISSION IS HEREBY GRANTED TO: Project# ROOF 2023 Contractor: License: WILDE HSE LLC DB SEXTON Est. Cost: 13800 ROOFING 106265 Const.Class: Exp.Date: 03/08/202' Use Group: Owner: SPENC R TABER D SHEARMAN & SARAH H Lot Size (sq.ft.) Zoning: URC Applicant: WILDE I SE LLC DBA SEXTON ROOFING Applicant Address Phone: Insurance: 45 OLANDER DR 315-569-7761 6HUBOW55113923 NORTHAMPTON, MA'01060 ISSUED ON: 08/03/2023 TO PERFORM THE FOLLOWING WORK: STRIP AND REROOF 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: • '' )2 CPI Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax (413)587-1272 Office of the Building Commiss a ner REEIVED St. The Commonwealth of Massach -etts AUG - 2 ?nil'. Lis Board of Building Regulations and S .nda s FO Massachusetts State Building Code, 7'0 C bF[tUu.o��>>�tsP � �IC1 ALITY NQRTHAMP?ON.MA Of060 Building Permit Application To Construct,Repair,R• -i •. i iemo is a Revised Mar 2011 One- or Two-Family Dwelling This Section For Official Use Only Building ennit Number: 3-a' L'J— L(T3Q Date Applied: i t'‘)ii.—) ii45 8- -20Z3 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&parcel Numbers to 6r4 e 1.1 a Is this an accepted street?yes no Map Number Parcel Number 13 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq 0) Frontage(It) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided i 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Zone: Outside Flood Zone? Public 0 Private 0 — Municipal ❑ On site disposal system 0 Check if_yes❑ SECTION 2: PROPERTY OWNERSHIIt 2.1 Owner'of Record: 1 kfAiattcx Pip. Mc i- f.16 ten, t-t-ik 00t-o0 Name(Print) City,State,ZIP 10 %Othti uv 41%3-26 -aaas crisp,e kr..(Q,�3,,.......e.. .gym No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK'`(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s)Al Alteration(s) 0 Addition ❑ Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work': ("beg re-plc wne..r4 con ylame-- SECTION 4:ESTIMATED CONSTRUCTION COSTS Estimated Costs: Item Official Use Only (Labor and Materials) 1. Building S i3 %CO 1. Building Permit Fee: $ Indicate how fee is determined: t 0 Standard City/Town Application Fee 2. Electrical S 0 Total Project Cost'(Item 6)x multiplier x 3. Plumbing S 2. Other Fees: S 4. Mechanical (HVAC) S List: 5. Mechanical (Fire S Total All Fees $ Suppression) Check No.1� Check Amount: Cash Amount: 6. Total Project Cost: S i 31 a00 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) Ic1DQ(Ds 31s 21 S44ck License Number Expiration Date Name of CSL Holder List CSL Type tsee below) 3l�trDr No.and Street Type Description U Uihrestricted(Buildings up to 35,000 cu.It.) OftHG,►'N NV' O bloO R Restricted 1&2 Family Dwelling City/Town,Stale,ZIP M M4sonry RC Rooting Covering WS Window and Siding SF Solid Fuel Burning Appliances S(D9-1-1Lll fm.ct�lno..eCr�-koncessZ.y. cor%-. I Insulation Telephone Email ade.es D Demolition 5.2 Registered Home Improvement Contractor(HIC) „1_4-10 I6/2 49.5 �►tat, 'a) c.eAkat, l2e t HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name �� Q -►' E>g- Gamma @ SQJd4an-eiSt-gNq.cei(1'1 No.and Street Email adds K6er e" NSA OtOLOt, 3694fil 111D I City/Town,State.ZIP Telephone 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 0 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 \i, stkrit. 'ra ' tell Q./Cwt.i St�,�•q to act on my behalf,in all matters relative to work authorized by this building permit application. d� k artc- Pre l•h,,c.etrru n{ 8 I k J 2423 Print Owner's Name(Electrons 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. swsl,o. ��(a1, I $1 1'2A,93 Print Owner's or Authorized Agent's Name(Electronic Signature) i Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will 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" City of Northamp on :� Massachusetts �4, — _stcl!` �.� DEPARTMENT OF BUILDING INSPE�ZlR11S ,7 212 Main Street • Municipal Suilainq yJ,y D" Northampton, MA 01060 j41.1. 1~, CONSTRUCTION DEBRIS AF'F!DAVIT (FOR ALL DEMOLITION AND RENOVA1IION 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. 1 The debris will be disposed of in: Location of Facility: (QS(o t�(o.i" S+ (-wim.,.. 141 (inc.d The debris will be transported by: Name of Hauler: Aric,,4"J (din tAlmiLAYS Signature of Applicant: Date: SI cJ 2oa3 .—` The Commonwealth of Massach ► —=—'•-=!i Department of Industrial Accide is —" 1 Congress Street,Suite 100 `;=_ ir��` Boston,MA 02114-2017 'Y ,'" www.massgov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Leeibly Name (Business/Organization/Individual): \t\At, \-N&E,1 U.S.- C.,(0Ats t 9,12Z ni�1 or Address: '-I5 04o,t<,;(e br City/State/Zip: Js( t ,plan, MA C.14240 Phone#: 315- Gto9--11 cc i Are you as employer?Check tbt appropriate box: Type of project(required): I am a employer with employees(full and/or part-time)• 7. New construction 2B am a once proprietor or partnership and have no employees working forms is 8. Remodeling any capacity.[No workers'comp.insurance required.) 9. Demolition 3E11 am a homeowner doing all work myself.[No workers'comp.insurance required.3 t 10 Building addition 401 am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensators insurance cr are sole 11 DElectrical repairs or additions proprietors with ao employees. 120Plumbing repairs or additions 5iZI am a general contractor and I have hired the sub-contractors listed on the attached sheet 13. Roof repairs These sub-contractors have employees and have workers'comp.insurance.: 60 We area corporation and its officers have exercised their right of exemption per MGL c. 14. Other 152,§1(4),and we haven employees.[No workers'romp.insurance required.] 'Any applicant that checks box 01 must also fill out the section below showing their workers'conspetmtion policy information. t Houneowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new aff.davit indicating such. ;Contractors that check this box must attached an additional sheet showing the tame of the sub-contractors and state whether or not those entities have employees. If the subcontractors have employees,they trust provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and fob site information. Insurance Company Name: Trrtvete ' ewi)lkj C1 Ar'vtet tee Policy#or Self-ins.Lic.#: (p 1s,1j, ,\N[651kaZl ' tion Date: re,(t 12O2!4 Job Site Address: t ti 'R.i Lct9 (fir City/State/Zip:i4tc4v.,. at rntslpo Attach a copy of the workers'compensation policy declaration page(showing the policy number andd capllrratlon date). Failure to secure coverage as required under MGL c.152,§25A is a criminal violation punishable by 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 S250.00 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 and penalties of perjury that the information provided above is true and correct. Signature: Sl-Sdr-- inDLIC/cl.__ Date: al ['z)21 Phone#: 5)S-slog-711nl Official use only. Do not write in this area,to be completed by city or town aficiaL City or Town: Permit/License# Issuing Authority(circle one): J.Board of Health 2.Building Department 3.City/Town Clerk 4.Elee Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#:_ —_ !i ACORL/ CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) `„./ 06/09/2023 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 CONTNAME ACT Eric Dembinske ORMSBY INSURANCE AGENCY {A,c,N,,E„): (413)737-0300 (NC.Nok E-MAIL ADDRESS: orms edembinske� � bY ins.Com P 0 BOX 718 F U RER(S AFFORDING COVERAGE NAICf WEST SPRINGFIELD MA 01090 INSURER A: TRAVELERS INDEMNITY CO OF AMERICA 25666 INSURED INSURER B: WILDE HSE LLC INSURER C: DBA SEXTON ROOFING &SIDING INSURERD: 45 OLANDER DRIVE INSURERE: NORTHAMPTON MA 01060 INSURER F: COVERAGES CERTIFICATE NUMBER: 901203 I 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 - - ---ADDLSUBR I DI POLICY EFF N POLICY EXP LIMITS LTR, TYPE OF INSURANCE INSR WVD POLICY NUMBER IMMIDYYYY) (MMIDDIYYYY)i COMMERCIAL GENERAL LIABILITY 1 EACH OCCURRENCE $ - 1 j DAMAGE TO RENTED _j CLAIMS-MADE OCCUR PREMISES jEa occurrence) $ MED EXP(Any one person) $ - j' N/A PERSONAL A ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY L. PRO-JECT ,_ I LOC PRODUCTS-COMP/OP AGG $ L_...J 4 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) j ANY AUTO BODILY INJURY(Per person) $ �I OWNED SCHEDULED AUTOS ONLY AUTOS N/A BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) I UMBRELLA LIAB OCCUR EACH OCCURRENCE $ ' EXCESS LIAR CLAIMS-MADE N/A AGGREGATE $ I DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY OTH- PER ATUTE ER Y/N ANYPROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 A OFFICER/MEMBEREXCLUDED? N/A N/A N/A 16HUB0W55113923 06/01/2023 06/01/2024 _-- (Mandatory in NH) E.L.DLSPASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below .E.L.DISEASE-POLICY LIMIT $ 1,000,000 N/A I DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwd/workers-compensation/investigations/. 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. Sexton Roofing and Siding Inc PO Box 6327 AUTHORIZED REPRESENTATIVE Holyoke MA 01040 Daniel M.Crowley,CPCU,Vice President—Residual Market—WCRIBMA 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ACORD Client# DATE TM CERTIFICATE OF LIABILITY INSURANCE 07/25/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHT 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 Gulherme Camossato AIAMF- PHONE 978 726-9830 I-INSURANCE GROUP INC (JC.No.Ext) EMAIL gcamossato@i-Insurancegroup.net 799 GORHAM ST ADDRESS LOWELL, MA 01852 INSURER(S)AFFORDING COVERAGE NAIC INSURED INSURER A:GENERAL STAR INDEMNITY COM INSURER B.ARBELLA PROTECTION INSURANCE LDG HOME IMPROVEMENT INC INSURER C: 18 SPRING ST FL1 INSURER D:TRAVELERS PROPERTY CAS CO OF AM MILFORD, MA 01757 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER.000015 REVISION NUMBER: 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 TALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN IY1AY HAVE BEEN REDUCED BY PAID CLAIMS. INSRL ADDLI SUBR POLICY EFF POLICY EXP TR TYPE OF INSURANCE NSR WVD POLICY NUMBER (MM/DD(YYYY) (MM/DOIYYYY LIMITS A GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000.00 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES IEa ocurrencel $ 100,000.00 CLAIMS-MADE IX I OCCUR MEDEXP(Any one person) $ 5,000.00 IMA395923A 8/25/2022 8/25/2023 PERSONAL a ADV INJURY $ 1,000,000.00 GENERAL AGGREGATE $ 2,000,000.00 GEN'L-AGGREGATE LIMIT APPLIES PER Products Completed Ops Aggregate $ 2,000,000.00 POUCY 1 PROJECT FILOC B COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY (Ea $ 100,000.00 -• BODILY INJURY(Per person) ANY AUTO S 20,000.00 ALL OWNED SCHEDULED 1020096012 4/13/2023 4/13/2024. BODILY INJURY(RP'accident )AUTOS AUTOS $ 40,000.00 NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS (Per accident) $ 100,009.00 UMBRELLA I EACH OCCURRENCE LIAR OCCUR EXCESS LIRE CLAIMS-MADEAGGREGATE DED[ RETENTION I • D WORKERS COMPENSATION YM ! WC STATUTORY OTH AND EMPLOYERS'UA&UTY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E L.EACH ACCIDENT OFFICER/MEMBER EXCLUDED' n/a $ l,000,000.00 6HUB4N86974323 3/26/2023 3/26/2024 IMandatory In NM E L DISEASE-EA EMPLOYEE $ 1,000,000.00 If yes,describe under DESCRIPTION OF OPERATIONS belay £L DISEASE-POLICY OMIT $ 1,000,000.00 GENERAL LIABILITY.'for regular and usual jobs and the certificate holder is an additional insured. Workers.Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B.no authorization Is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance) The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Venfication Search tool at www.mass.gov/wdhworkers-compensation/investigations/ CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE IT IS THE CUSTOMER'S RESPONSABILITY TO INFORME ANY SEXTON ROOFING CHANGES OR CANCELATIONS 45 Olander Dr., Northampton, MA GUILHERME CAMOSSATO 1/1 ©1988-2010 ACORD CORPORATION.All rights reserved. ACORN' DATE(NNI�DemYY) �� CERTIFICATE OF LIABILITY IN$JRANCE 05/31/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED„subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in Neu of such endorsements). Pnootrevit Cmi a BRUNO ROZE BARQUE POINT INSURANCE INC HONE 17)78311ti0 FAX i/4tC Tb.r iNC,Rol: AOORESS- bruTDOpointinsTreecoeu 1103 COMMONWEALTH AVE TIieURER(S)AFFORDING COVERAGE RAW* BOSTON MA 022151111 rOURER A_ AIM MUTUAL INS CO 33758 RNe1RtED INSURER e: E C A GENERAL CONSTRUCTION INC INSURER C: INSURER D: 8 OTIS ST APT 1 INSURER E: MILFORD MA 01757 INSURER F: COVERAGES CERTIFICATE NUMBER: 897535 REVISION NUMBER: THIS IS TO CERJWY HAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY t TAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CORA*TIONS OF SUCH POLICES.LRETS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS EXP LLTTRR ADDL. POLICY EFF 1 TYPE OF INSURANCE 1w n POLICY PNI BER tmee�' TO&YVYYI Lana COITAL GE5tRAL Lrka4.XTY• 1 EACH OCCURRENCE f I GLMMS.MADE i OCCUR RENTED :.PRFYSEDAIULGE$ omsnxroe) $ MEDEliP(Atyronepemei $ N/A IPERSONAL>EADVesL INJURY $ GOII ARGISER ATE UMITAPPLIES PERr GGENERAL A[ EGATE $ POW!I I JEGT L !WC k PRODUCTS-COLWAP AGG S ODEW ' i S COMBINED SIMILE LIMIT AurorlDerLeLueILTTY tea accident) $ ANY AUTO BDD'LY WITTY(Per person) $ Y MHOS SCHEDULED N/A BCHLY INJURY(Par dcddent) $ HIED NONOANED •PROPERTY D ADGE $ _ AUTOS ONLY -_ AUTOS ONLY IPA NocidMNll' $ i rNB1eBU►ItiA6 f Clr:['eR EAGSIOaD. 5NCE $ EXCESS IIAB CLAW—MADE N/A AGGREGATE I e DEC r RETENTION; s WORKERS COMPENSATION X STATUTE ER AND EaWLOYERSS'UAetUTY AA'�.tc.=W£F'04iSy1RT�E YI M El-EAOR ACCIDENT S 1,000.000 A o�Frl:,.. .. oaa UDECN n NIA ND VYYC10060260282(rz 021112023 02111/2024 (Nandalory in NH) EL.CJce* F-EA EMPLOYEE $ 1,000,000 ?AA p y IF Or OPERATIONS ear L.Y EL DISEASE-POL UWI $ 1.000.000 N/A i D£SerN'UDN OF OPETOR10NS i LOCATIONS I VEHICLES µCORD Set,AddllieadRsnraiIs 3eieide,new be altachd Coins acme is aequteer8 Workers'Corripensation benefits vall be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay dams for benefits to employees n states other than Massachusetts if the insured hires,or has hired those errpioyees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of thris certificate of insurance). The status of this coverage can be monitored daffy by accessing the Proof of Coverage-Coverage Verification Search toil at agvw.mass.gavihvd aorke*s-oompersatior~t`investigaoonst. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN POUCY Wilde HSE LLC A WITH 7H E PROVISIONS. 45 Ctander Dr AUTHOIR tEDBINI TIVE Northampton MA 01060 4 Daniel Qrl�.CPCU,Vice President—Residual Market—WCRIBMA 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Licensee Details Demographic Information Full Name: SASHA MARIE WILDE Owner Name: license Address ss information I Ffty NORTHAMPTON State: MA Zipcode: 01060 Country: United States License Information License No: CSSL-106265 License Type: Construction Supervisor Specialty Profession: Building Licenses Date of Last Renewal: Issue Date: 7/6/2023 Expiration Date: 3/8/2027 License Status: Active Today's Date: 7/7/2023 Secondary License Type: Doing Business As: Status Chance Reason: License Issuance Prerequisite Information No Prerequisite Information No Available Documents - THE COMMONWEALTH Of MASS Ar- HUSETTS Office of Consumer Affairs and Bunn ss Regulation i NO Washington Street-Suite 710 Boston, Massachusafls 02118 Home Improvement Contractor Reistratlon Typo LLC ation 2tid47G Ji'..GE o4SE.PL plrbDC E ors 4tr30/1L25 0 B•A SEXTON ROOFitWG 8 SIDING ai IDIA iDER DR 14ORTMAMPTON MA 03104 Vodais 4ddrws and ROW,Core. THE CSVMOMM ALTH OP MASSACHUSETTS O10iu of Canaumrsr Ar'aws 6 Mu.m.ss R10utason Registration wild for IndivWual use onty seism the M:9E tMP'AVYEMEN1 CONTRACTOR eiseetioe etasIt Oi TYPE_L/C OlSos of Csipmww Man and&minas*Rigutabarr Rsstittallao Eaairalsi TOW WoolPoinfeen arms 1•WIM 710 ?ti641:t CoLlef Ua5 eaatws,RA OM. h':CiE,-SE.u: 011.4 sExtON R'4$1O I 6,0443 45Ot/WDER OR ��,F1+.;• .-+:+A. C. 1, trtr y"o., __._ NORTHAMPTON,MA C7tG+ iJndstsaicrs'taly Not valid minnow signature WILDE IISE, SEXTON ROOFING A 4D SIDING www.sextonroofing.com p.413.534.1234 rigor �r info@sextonroofing.com lIMO 45 Colander Dr. Setting the Standard MA HiC#208470 Northampton, MA 01040 SUBMT TEDTO Kendrick Property Management ' Pt-IONE 14i 253-0825 J DATE i 7128/2023 STREET IO Bixby Court EMAIL J scott(akendrickmanagenient.com CITY,STATE,ZIP Northampton MA 01060 ru(+tr SEXTON ROOFING HEREBY SUBMITS SPECIFICATIONS AND ESTIMATES Fat I) Strip and remove existing,shingles and dispose of in proper landfill. Z} Inspect roofing deck and replace as needed @$105.00 per sheet. 3) Install new metal edging to rakes and eaves of roof.+;white) 4) Install ice and water shield on eaves(6').vent stacks.in valleys,chimney,at intersecting roofs. S) Install synthetic roofing underlayment on remainder of roof 6) Install'new flanges over existing vent stacks. 7) Install`starter shingles on eaves and rakes of roof. B) install IKO Architectural style roofing shingles as per manufacturers`spe ifications.Color:Charcoal Gray 9) Supply manufactures Lifetime warranty and SRC tO yr:workmanship wa anty. ATTENTION HOMEOWNERS:Please cover all personal belongings-in the attic,garage,or storage areas due to possible r +{+ling debris or dust coming through cracks of wood decking. Sexton Rooting shall apply for all permits. We propose hereby to furnish material and labor-complete in accordance with the above specifications,for the sum of Thirteen thousand eight hundred dollars($13,800) Payment due in full upon completion AI?Material is guaranteed to he as specified, Alfvcork rotnpleted in a workmanlike manner according to standard practices. Any alteration or deviation from above specifications Authorized a /,�`) involving extra costs wilt be executed only upon written orders. Signature �(J from_' and will become an extra charge over and above the estimate. DAMAGES TO BUSHES AND OTHER VEGETATION'MARKS ON HOUSE MAY BE UNAVOIDABLE AND WE ARE HELD HARMLESS. Now'This proposal may be withdrawn by us if not accepted within Not responsible for water damage during construction, Owner to (4)days. pay responsible legal fees for non-payment,andapplicable ` �l interest. i1 Acceptance of Proposal The above -)nature prices,. e't u � ,�, —� k specifications and conditions are satisfactory and are Signature hereby accepted. You-are authorized to do-the work as / ''c �' ,a ,t [•"` specified. Payment will be made as outlined above. [late / — 3